DOI: https://dx.doi.org/10.18203/2349-2902.isj20180446
Published: 2018-02-26

Role of total leukocyte count and C-reactive protein in diagnosis of acute appendicitis

Anuradha Dnyanmote, Sagar Ramesh Ambre, Foram Doshi, Snehal Ambre

Abstract


Background: Acute appendicitis is still one of the most common surgical emergencies. This study was conducted to check the sensitivity and specificity of Total leukocyte count (TLC) and C Reactive Protein (CRP) of acute appendicitis. Aim and objectives were to check the sensitivity and specificity of total leukocyte count in diagnosis of acute appendicitis and to check the sensitivity and specificity of CRP in diagnosis of acute appendicitis. To determine TLC and CRP efficacy in diagnosis of acute appendicitis.

Methods: TLC and CRP were calculated in all patients who were planned to undergo appendectomy. Appendectomies were performed independent of results of TLC and CRP levels. For statistical purpose the patients were assigned into 2 groups- Group-A Patients with inflamed/perforated/gangrenous appendix, Group-B patients with Normal appendix. The normal TLC and CRP values, raised TLC, raised CRP, and raised both TLC and CRP values calculated in each of these groups. Sensitivity and Specificity were calculated. The cut off value for TLC was 11x106/L. This value was selected arbitrarily as it corresponds to the elevated TLC. The CRP levels were calculated and cut off value was taken as 1.7mg/dl.

Results: Out of 75 cases, 55 were male and 20 were female. Age ranged from 13 to 58 years. CRP was raised in 82.14% of inflamed appendix cases TLC was raised in 76.79% of inflamed appendix cases and both was raised in 92.5% of inflamed appendix cases.

Conclusions: TLC and CRP are useful in diagnosis of acute appendicitis. Negative appendicectomy rate can be decreased.


Keywords


CRP, TLC

Full Text:

PDF

References


Asfar S, Safar H, Khoursheed M, Dashti H, Al-Bader A. Would measurement of C-reactive protein reduce the rate of negative exploration for acute appendicitis?. J Royal Coll Surg Edinburgh. 2000;45(1):21-4.

Jess P, Bjerregaard B, Brynitz S, Holst-Christensen J, Kalaja E, Lund-Kristensen J. Acute appendicitis: prospective trial concerning diagnostic accuracy and complications. Am J Surg. 1981;141(2):232-4.

Pieper R, Kager L, Näsman P. Acute appendicitis: a clinical study of 1018 cases of emergency appendectomy. Acta Chirurgica Scandinavica. 1982;148(1):51-62.

Hoffmann J, Rasmussen O. Aids in the diagnosis of acute appendicitis. BJS. 1989;76(8):774-9.

Grönroos JM, Forsström JJ, Irjala K, Nevalainen TJ. Phospholipase A2, C-reactive protein, and white blood cell count in the diagnosis of acute appendicitis. Clin chem. 1994;40(9):1757-60.

Delany HM. Appendicitis: trends and risks, 1996. Journal of the Association for Academic Minority Physicians: the official publication of the Association for Academic Minority Physicians. 1996;7(3):70-7.

van Dieijen-Visser MP, Brombacher PJ. The value of laboratory tests in patients suspected of acute appendicitis. Clini Chem Lab Med. 1991;29(11):749-52.

Andersson RE, Hugander A, Thulin AJ. Diagnostic accuracy and perforation rate in appendicitis: association with age and sex of the patient and with appendicectomy rate. European J Surg Acta chirurgica. 1992;158(1):37-41.

Gurleyik E, Gurleyik G, Unalmiser S. Accuracy of serum C-reactive protein measurements in diagnosis of acute appendicitis compared with surgeon's clinical impression. Dis Colon Rect. 1995;38(12):1270-4.

Balthazar EJ, Birnbaum BA, Yee J, Megibow AJ, Roshkow J, Gray C. Acute appendicitis: CT and US correlation in 100 patients. Radiol. 1994;190(1):31-5.

Mason LB, Deyden WE. Primary appendectomy. Am J Surg. 1976;42:239-43.

Lewis FR, Holcroft JW, Boey J, Dunphy JE. Appendicitis: a critical review of diagnosis and treatment in 1,000 cases. Arch Surg. 1975;110(5):677-84.

Chang FC, Hogle HH, Welling DR. The fate of the negative appendix. Am J Surg. 1973 D;126(6):752-4.

Webster DP, Schneider CN, Cheche S, Daar AA, Miller G. Differentiating acute appendicitis from pelvic inflammatory disease in women of childbearing age. Am J Emerg Med. 1993;11(6):569-72.

Shakhatreh HS. The accuracy of C-reactive protein in the diagnosis of acute appendicitis compared with that of clinical diagnosis. Medicinski arhiv. 2000;54(2):109-10.

Wilcox RT, Traverso LW. Have the evaluation and treatment of acute appendicitis changed with new technology?. Surgical Clinics. 1997;77(6):1355-70.

Shine B, De Beer FC, Pepys MB. Solid phase radioimmunoassays for human C-reactive protein. Clinica chimica acta. 1981;117(1):13-23.

Rodríguez-Sanjuán JC, Martín-Parra JI, Seco I, García-Castrillo L, Naranjo A. C-reactive protein and leukocyte count in the diagnosis of acute appendicitis in children. Dis Colon Rect. 1999;42(10):1325-9.