Leukocyte subpopulations in pediatric complicated appendicitis is a time stable pattern

Abstract

Introduction: Acute abdominal pain is one of the most frequent complaints for which children and adolescents seek treatment in the emergency department (ED). Reported rates of misdiagnosis in children vary from 3.8 to 15% and misdiagnosis in adults 5.9-23.5% respectively. Together with clinical parameters laboratory values are of special relevance within the diagnosis and decision making within the disease. Next to classical laboratory values like C-reactive protein (CRP) and leukocytes, serum sodium concentrations, the neutrophil-to-lymphocyte ratio and new inflammatory markers like chemokines and special enzymes might be used for the discrimination of complicated appendicitis. However, clinical decision-making just on biomarkers is still not feasible because of great interindividual differences in the inflammatory process. Methods: Our study was performed on 186 children admitted for suspected acute appendicitis and underwent appendectomy at the MNCMCH, Ulaanbaatar Mongolia, between June 2020 and September 2020. The two groups of complicated (gangrenous and perforated) and noncomplicated (cattarhal and phlegmonous) acute appendicitis were compared. Results: From a total of 186 patients, 119 were male, the mean age was 10.21 ± 1.22. There were no significant differences between complicated and uncomplicated group concerning gender and age (p=0.243) (p=0.491). In all cases, the highest diagnostic accuracy is for white blood cells, neutrophils, and eosinophils.In conclusion, our analysis suggests fundamental and stable diferences between cellular compositions in WBCs of patients with phlegmonous and complicated appendicitis. ttempts to identify and establish suitable time independent and more effective biomarkers seem to be reasonable.