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Association rate of leukocytosis increased CRP and ESR with acute appendicitis
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M Berenji   , AR Yarabbi , N EshaghHoseini , R GhaziSaeadi , V Vagharian |
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Abstract: (15202 Views) |
Introduction: Acute appendicitis is one of the most common problems
requiring emergency surgery. Diagnosis is based on history,
physical examination and laboratory findings. Rate of misdiagnosis
of appendicitis especially in female is up to 23.2 %. Some basic
laboratory examinations such us white blood cell count, CRP and
ESR have been suggested as aids in the diagnosis of acute
appendicitis. But results are controversial.
Objective: This study was designed to evaluate the association
between leukocytosis, increased CRP and ESR and acute
appendicitis.
Materials and Methods: In this retrospective study, 200 patients were
admitted with clinical diagnosis of acute appendicitis from October
2009 to March 2010 in Booali hospital in Tehran. Blood samples for
WBC, CPR and ESR were sent to the laboratory preoperatively.
Then sensitivity, specificity, positive and negative predictive value
(PPV and NPV) of these tests were determined and analyzed.
Results: There were 124 males (62%) and 76 females (38%) The
mean age was 29 years range 15 to 80 years. 186 (93%) patients
have histologically confirmed appendicitis and 14 (7%) had normal
appendix. Sensitivity, specificity, PPV and NPV for leukocytosis
were in order: 84.5%, 34%, 92% and 16.7% for increased CRP
were in order 75.3%, 28%, 91.4% and 11%, and for increased ESR
were: 72%, 22%, 90.5%, 5%, respectively. When all tests are used
for diagnosis, these criteria were 56%, 68.5%, 96.3% and 10.9%
respectively. In attention to sensitivity and value of positive (PPV)
and increased WBC, CRP and ESR, it can be resulted that positive
value of these tests in suspected appendicitis can strengthen the
clinical diagnosis but lowered value of negative (NPV) testes
showed that the negativity of each test or all tests together cannot
verify acute appendicitis.
Conclusion: In presence of leukocytosis, increased CPR & ESR
probability of appendicitis was increased in clinically acute
appendicitis. But normal value of WBC, CRP&ESR don't rule out
acute appendicitis. |
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| Keywords: Acute appendicitis, Leukocytosis, CRP, ESR |
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Full-Text [PDF 300 kb]
(6378 Downloads)
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Type of Study: Original |
Received: 2012/03/6 | Accepted: 2014/06/3 | Published: 2014/06/3
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