Role of serum cytokines in acute appendicitis and acute mesenteric lymphadenitis among children

Abstract

Funding Information: The study was financially supported by a Grant No. 2009/0147/1DP/1.1.2.1.2/09/IPIA/VIAA/009 from the project Support for Doctoral and Post-doctoral Investigations Riga Stradiņš University fellowship and a Grant No. 2010.10-4/VPP-4 of the framework of the Latvian National Program and also by The national Research program project Biomedicine for public health (BIOMEDICINE) No 6.1 “Research on acute and chronic diseases in a wide age-range children to develop diagnostic and therapeutic algorithms to reduce mortality, prolong survival and improve quality of life”. Publisher Copyright: © 2016 The Lithuanian University of Health SciencesBackground and objective The diagnostic role of serum cytokines depends on the etiology and pathogenesis of acute appendicitis (AA) and acute mesenteric lymphadenitis (AML). The aim of this study was to evaluate differences in cytokine levels between AA and AML. Materials and methods Data of 7- to 18-year-old children were collected prospectively from October 2010 to October 2013. There were 31 patients with AA (AA group), 26 with AML (AML group), and 17 with elective non-inflammatory surgical disease (control group). Serum levels of IL-10, IL-12(p70), IL-1β, IL-4, IL-6, IL-8, IL-17, MCP-1, EGF, TNF-α and white blood count (WBC) were measured three times consecutively in each group. Results The level of IL-6 and IL-10 was significantly higher in the AA group than the AML group at the first measurement (8 pg/mL vs. 3.2 pg/mL, P = 0.000; 6.1 pg/mL vs. 3.2 pg/mL, P = 0.005, respectively). There was a significant difference observed in time dynamics of concentration of IL-6 and MCP-1 for AA and AML. The area under the curve (AUC) was 0.77 (95% CI 0.64–0.89; P = 0.001) for IL-6 with a cut-off value of 4.3 pg/mL (67.7% sensitivity and 76.9% specificity) for AA 1 h before surgery. The AUC for WBC was 0.72 (95% CI 0.58.4–0.85; P = 0.005) with a cut-off value of 10.7 × 103/μL (sensitivity 71.0% and specificity 46.2%). Conclusions Serum IL-6 with a cut-off value of 4.3 pg/mL and WBC with a cut-off value of 10.7 × 103/μL assessed together will yield more sensitivity for AA.publishersversionPeer reviewe