The Usefulness of Procalcitonin in the Diagnosis of Appendicitis in Children: A Pilot StudyReport as inadecuate




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Emergency Medicine InternationalVolume 2012 2012, Article ID 317504, 5 pages

Clinical Study

Department of Emergency Medicine, Maimonides Medical Center, 4802 Tenth Avenue, Brooklyn, NY 11219, USA

Division of Pediatric Emergency Medicine, Morgan Stanley Children Hospital of New York-Presbyterian, 622 West 168th Street, PH 137-1, New York, NY 10032, USA

Received 21 May 2012; Revised 11 November 2012; Accepted 11 November 2012

Academic Editor: Mucahit Emet

Copyright © 2012 Abu N. G. A. Khan et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Objective. To assess the predictive value of procalcitonin in detecting acute appendicitis AP in children, and to determine a cutoff value of procalcitonin which can safely include-exclude the diagnosis of acute appendicitis in children with acute abdominal pain. Methods. Prospective cohort study of children aged 5–17 years presenting to the emergency room with right lower quadrant RLQ tenderness and strong suspicion for acute AP. In addition to standard diagnostic workup for acute AP, a quantitative procalcitonin level was measured using immunoluminometric assay. Recursive partitioning model was used to assess the usefulness of procalcitonin in the diagnosis of appendicitis. Results. Of the 50 children studied, 48% were diagnosed to have AP. The mean procalcitonin level was higher among the children with appendicitis . Using the recursive partitioning model, we identified a cutoff value of procalcitonin level of 0.39 with a likelihood ratio presence of appendicitis 3.25 and absence of appendicitis 0.8. None of the study subjects with procalcitonin level <0.39 and WBC count of <6.76 K had appendicitis. Conclusions. In conjunction with the clinical symptoms, a procalcitonin level and WBC count could be a strong predictor of acute appendicitis in children.





Author: Abu N. G. A. Khan, Abdel Sawan, Antonios Likourezos, Mark Schnellinger, and Estavan Garcia

Source: https://www.hindawi.com/



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