Determination of pentraxin 3 levels in diagnosis of appendicitis in children

Abstract

Background The aim of this study is to determine the pentraxin3(PTX3) levels as an acute phase reactant in diagnosis of appendicitis in children. Methods Fifteen children who were under 18 years old who gave blood samples due to the reasons rather than inflammatory conditions and forty children who were proved to have appendicitis (non‐perforated or perforated) between August 2017 and January 2018 were enrolled to the study. Patients are classified into subgroups as Group 1 (healthy children without any sign of inflammation, n=15), Group 2 (non‐perforated appendicitis,n=25), Group 3 (perforated appendicitis, n=15). Results The median PTX3 value was 1.01ng/mL (minimum value: 0.82, max: 1.28) in the control group. Median PTX3 value prior to surgery were 20,68ng/mL (min: 1.02, max: 28.471) and 1.46 (min: 1.05, max: 23.421) ng/mL for non‐perforated appendicitis and perforated appendicitis respectively. PTX3 levels were significantly higher in the Group 2 and 3 compared to group 1(p<0.01). According to ROC analysis the cut off value of PTX3 levels at admission for appendicitis was 1.30ng/mL with a sensitivity of 75% and a specificity of 100% (area under the curve, 0.939; P =0.000,). Conclusions PTX3 levels were significantly higher in children with appendicitis compared to healthy children. The children with high PTX3 levels with complaint of right lower quadrant pain may support diagnosis of appendicitis. Future studies evaluating the alteration in PTX3 levels by comparing the children with appendicitis versus acute abdominal pain in larger populations should be conducted to further determine the differential value of PTX3 in diagnosis of appendicitis in children.