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ISSN 0185-6014 (Print)
Órgano oficial de difusión de la Federación Mexicana de Patología Clínica, AC y de la Asociación Latinoamericana de Patología Clínica/Medicina de Laboratorio

2005, Number 3

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Rev Mex Patol Clin Med Lab 2005; 52 (3)

C-reactive protein for acute appendicitis diagnosis

Padierna-Luna JL, Ruiz-Valenzuela KL, Morales-Arellano AC

Language: Spanish
References: 19
Page: 58-62
PDF size: 107.42 Kb.


ABSTRACT

Objective: to determine the utility of C-rective protein (CRP) in the early diagnostic of the acute appendicitis. Design: prospective trial on 70 patients with clinical suspect of acute appendicitis. Patients with connective tissue disease, abdominal trauma, bad control diabetes mellitus and myocardial infarction were excluded. They were taken sample of veined blood for hematic cytology and CRP. Surgeon that it intervened he/she didn’t know about the report of CRP. CRP level were related with time of clinical evolution, leukocyte count and histological examination. Finally, sensitivity, specificity was calculated. Results: The males were most prevalent (54%). The mean age was of 32 years (range 6 to 74). Histopathology was classified in four groups and its frequency was: A) acute appendicitis (15.7%); B) appendicular abscess (15.7%); C) perforated appendicitis (51.7%) and D) normal appendix (17.1%). The CRP was positive in the patients 98.3% with appendicitis and its elevation went proportional to the complications grade and it counts of leukocytes. It find sensitivity of the CPR for acute appendicitis of 98% and specificity was 67%. Conclusions: The results of this study are consistent with that reported in the literature and it corroborates that the CPR is usefulness test for the early diagnosis of acute appendicitis, in addition to the clinical study and it counts leukocytes.


REFERENCES

  1. Schwartz SI. Appendix. In: Swartz SI. Principles of surgery. 7a. ed. Nueva York: McGraw Hill, 2000; 1307-1318.

  2. Gronroos JM. Is there a role for leukocyte and CRP measurements in the diagnosis of acute appendicitis in the elderly? Maturitas 1999; 31 (3): 255-258.

  3. Flum DR, Koepsell T. The clinical and economic correlates of misdiagnosed appendicitis: nationwide analysis. Arch Surg 2002; 137 (7): 799-8043.

  4. Kim-Choy N, Shih-Wei L. Clinical analysis for related factors in acute appendicitis. Yale J Biol Med 2002; 75: 41-45.

  5. Bratton S et al. Acute appendicitis risks of complications: age and medicaid insurance. Pediatrics 2000; 106 (1): 75-78.

  6. Asfar S. Would measurement of C-reactive protein reduce the rate of negative exploration for acute appendicitis? JR Coll Surg Edinb 2000; 45: 21-24.

  7. Garcia-Peña B et al. Effect of an imaging protocol on clinical outcomes among pediatric patients with appendicitis. Pediatrics 2002; 110 (6): 1088-1093.

  8. Birnbaum BA, Wilson SR. Appendicitis at the millennium. Radiology 2000; 215: 337-348.

  9. Jones FP. Suspected acute appendicitis: trends in management over 30 years. Br J Surg 2001; 88 (12): 1770-1577.

  10. Neumayer L, Kennedy A. Imaging in appendicitis: A review with special emphasis on the treatment the women. Obstetr Gynecol 2003; 102: 1404-1409.

  11. Caldwell M et al: Peritoneal aspiration cytology as a diagnosis aid in acute appendicitis. Br J Surg 1994; 81 (2): 276-278.

  12. Gronroos JM, Forsstrom JJ, Irjala K, Nevalainen TJ. Phospholipase A2, C-reactive protein, and whithe cell count in the diagnosis of acute appendicitis. Clin Chem 1994; 40: 1757-1760.

  13. Gronroos JM. Do normal leucocyte count and C-reactive protein value exclude acute appendicitis in children? Acta Paediatr 2001; 90 (6): 649-651.

  14. Gronroos JM, Gronroos P. Leucocyte count and C-reactive protein in the diagnosis of acute appendicitis. Br J Surg 1999; 86 (4): 501-504

  15. Albu E et al. Diagnostic Value of C-reactive protein in acute appendicitis. Dis Colon Rectum 1994; 37 (1): 49-51.

  16. King DE et al. C-reactive protein and glycemic control in adults with diabetes. Diabetes Care 2003; 26 (5): 1535-1539.

  17. Harrison F, Wood MD. et al, The occurrence during acute infections of protein not normally present in the blood. J Exp Med 1954.

  18. Guzmán-Valdivia Gómez G. Una útil clasificación para apendicitis aguda. Rev Gastroenterol Mex 2003; 68 (4): 261-265.

  19. Andersson RBE. Meta-analysis of the clinical and laboratory diagnosis of appendicitis. Br J Surg 2004; 91 (1): 28-37.




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