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IL-6 Serum Levels Can Enhance the Diagnostic Power of Standard Blood Tests for Acute Appendicitis

Background: The diagnosis of acute appendicitis (AA) remains challenging, especially in pediatrics, because early symptoms are not specific, and the younger the patient the more difficult their interpretation is. There is a large degree of agreement between pediatric surgeons on the importance of an...

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Autores principales: Di Mitri, Marco, Parente, Giovanni, Bonfiglioli, Giulia, Thomas, Eduje, Bisanti, Cristian, Cordola, Chiara, Vastano, Marzia, Cravano, Sara, Collautti, Edoardo, Di Carmine, Annalisa, D’Antonio, Simone, Gargano, Tommaso, Libri, Michele, Lima, Mario
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9600576/
https://www.ncbi.nlm.nih.gov/pubmed/36291361
http://dx.doi.org/10.3390/children9101425
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author Di Mitri, Marco
Parente, Giovanni
Bonfiglioli, Giulia
Thomas, Eduje
Bisanti, Cristian
Cordola, Chiara
Vastano, Marzia
Cravano, Sara
Collautti, Edoardo
Di Carmine, Annalisa
D’Antonio, Simone
Gargano, Tommaso
Libri, Michele
Lima, Mario
author_facet Di Mitri, Marco
Parente, Giovanni
Bonfiglioli, Giulia
Thomas, Eduje
Bisanti, Cristian
Cordola, Chiara
Vastano, Marzia
Cravano, Sara
Collautti, Edoardo
Di Carmine, Annalisa
D’Antonio, Simone
Gargano, Tommaso
Libri, Michele
Lima, Mario
author_sort Di Mitri, Marco
collection PubMed
description Background: The diagnosis of acute appendicitis (AA) remains challenging, especially in pediatrics, because early symptoms are not specific, and the younger the patient the more difficult their interpretation is. There is a large degree of agreement between pediatric surgeons on the importance of an early diagnosis to avoid complicated acute appendicitis (CAA) and its consequences. The aim of this study is to assess if Interleukin 6 (IL-6) could enhance the sensitivity (Sn) and specificity (Sp) of the currently available and routinely performed diagnostic tools in case of suspected AA in pediatric patients. Materials and Methods: A prospective observational study was conducted including patients who underwent appendectomy between November 2020 and March 2022. We divided patients into three groups: not inflamed appendix (group NA), not complicated AA (group NCAA), and complicated AA (group CAA). We compared the mean values of white blood cells (WBC), neutrophils, fibrinogen, ferritin, aPTT, INR, C-reactive protein (CRP), IL-6, and CRP between the three groups. Then we evaluated Sn, Sp, and odds ratio (OR) of IL-6 and CRP alone and combined. Results: We enrolled 107 patients operated on for AA (22 in Group NA, 63 in Group NCAA, and 21 in group CAA). CRP levels resulted in a significant increase when comparing CAA with NA (p = 0.01) and CAA with NCAA (p = 0.01), whereas no significance was found between NA and NCAA (p = 0.38). A statistically significant increase in average IL-6 levels was found when comparing NCAA with NA (p = 0.04), CAA with NA (p = 0.04), and CAA with NCAA (p = 0.02). Considering CRP alone, its Sn, Sp, and OR in distinguishing NA from AA (both NCAA and CAA together) are 86%, 35%, and 33,17, respectively. Similarly, Sn, Sp, and OR of IL-6 alone are 82%, 54%, and 56, respectively. Combining CRP and IL-6 serum levels together, the Sn increases drastically to 100% with an Sp of 40% and OR of 77. Conclusions: Our study may suggest an important role of IL-6 in the detection of AA in its early stage, especially when coupled with CRP.
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spelling pubmed-96005762022-10-27 IL-6 Serum Levels Can Enhance the Diagnostic Power of Standard Blood Tests for Acute Appendicitis Di Mitri, Marco Parente, Giovanni Bonfiglioli, Giulia Thomas, Eduje Bisanti, Cristian Cordola, Chiara Vastano, Marzia Cravano, Sara Collautti, Edoardo Di Carmine, Annalisa D’Antonio, Simone Gargano, Tommaso Libri, Michele Lima, Mario Children (Basel) Article Background: The diagnosis of acute appendicitis (AA) remains challenging, especially in pediatrics, because early symptoms are not specific, and the younger the patient the more difficult their interpretation is. There is a large degree of agreement between pediatric surgeons on the importance of an early diagnosis to avoid complicated acute appendicitis (CAA) and its consequences. The aim of this study is to assess if Interleukin 6 (IL-6) could enhance the sensitivity (Sn) and specificity (Sp) of the currently available and routinely performed diagnostic tools in case of suspected AA in pediatric patients. Materials and Methods: A prospective observational study was conducted including patients who underwent appendectomy between November 2020 and March 2022. We divided patients into three groups: not inflamed appendix (group NA), not complicated AA (group NCAA), and complicated AA (group CAA). We compared the mean values of white blood cells (WBC), neutrophils, fibrinogen, ferritin, aPTT, INR, C-reactive protein (CRP), IL-6, and CRP between the three groups. Then we evaluated Sn, Sp, and odds ratio (OR) of IL-6 and CRP alone and combined. Results: We enrolled 107 patients operated on for AA (22 in Group NA, 63 in Group NCAA, and 21 in group CAA). CRP levels resulted in a significant increase when comparing CAA with NA (p = 0.01) and CAA with NCAA (p = 0.01), whereas no significance was found between NA and NCAA (p = 0.38). A statistically significant increase in average IL-6 levels was found when comparing NCAA with NA (p = 0.04), CAA with NA (p = 0.04), and CAA with NCAA (p = 0.02). Considering CRP alone, its Sn, Sp, and OR in distinguishing NA from AA (both NCAA and CAA together) are 86%, 35%, and 33,17, respectively. Similarly, Sn, Sp, and OR of IL-6 alone are 82%, 54%, and 56, respectively. Combining CRP and IL-6 serum levels together, the Sn increases drastically to 100% with an Sp of 40% and OR of 77. Conclusions: Our study may suggest an important role of IL-6 in the detection of AA in its early stage, especially when coupled with CRP. MDPI 2022-09-20 /pmc/articles/PMC9600576/ /pubmed/36291361 http://dx.doi.org/10.3390/children9101425 Text en © 2022 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Di Mitri, Marco
Parente, Giovanni
Bonfiglioli, Giulia
Thomas, Eduje
Bisanti, Cristian
Cordola, Chiara
Vastano, Marzia
Cravano, Sara
Collautti, Edoardo
Di Carmine, Annalisa
D’Antonio, Simone
Gargano, Tommaso
Libri, Michele
Lima, Mario
IL-6 Serum Levels Can Enhance the Diagnostic Power of Standard Blood Tests for Acute Appendicitis
title IL-6 Serum Levels Can Enhance the Diagnostic Power of Standard Blood Tests for Acute Appendicitis
title_full IL-6 Serum Levels Can Enhance the Diagnostic Power of Standard Blood Tests for Acute Appendicitis
title_fullStr IL-6 Serum Levels Can Enhance the Diagnostic Power of Standard Blood Tests for Acute Appendicitis
title_full_unstemmed IL-6 Serum Levels Can Enhance the Diagnostic Power of Standard Blood Tests for Acute Appendicitis
title_short IL-6 Serum Levels Can Enhance the Diagnostic Power of Standard Blood Tests for Acute Appendicitis
title_sort il-6 serum levels can enhance the diagnostic power of standard blood tests for acute appendicitis
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9600576/
https://www.ncbi.nlm.nih.gov/pubmed/36291361
http://dx.doi.org/10.3390/children9101425
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