Document Type : Original Article

Authors

1 Assistant professor, Department of Surgery, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran.

2 MD, Department of Medicine, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran.

3 Ph.D Candidate, Department of Occupational Therapy, School of Rehabilitation, Iran University of Medical Sciences, Tehran, Iran.

10.21859/sums-2305782

Abstract

Objectives Appendicitis is the most common and important emergency condition, in which most of the patients undergo appendectomy. The diagnosis of appendicitis is critical and the values of diagnostic laboratory tests are always discussed. The current study aimed at determining the diagnostic value of C-Reactive Protein (CRP) increase in the diagnosis of acute appendicitis.
Methods The current cross sectional study examined 105 individuals referred to the emergency department of Shahid Motahari Hospital, Marvdasht, Iran, in 1012. Before the administration of any preoperational antibiotics, blood samples were obtained from the subjects to measure the serum CRP level. After surgery, the relationship among serum levels of CRP and appendix tissue biopsy, and the surgeon`s comments about the type of tissue were investigated. All data were analyzed by SPSS version 18, employing ANOVA and Tukey test.
Results A total of 81 patients had acute appendicitis, out of which 24 had normal appendix. Among patients with acute appendicitis, 65 subjects showed increased serum CRP level and 16 subjects had normal serum CRP level. The sensitivity and specificity of CRP level in the study were 80% and 63%, respectively.
Conclusion The results showed that evaluation of serum CRP levels can be useful and beneficial to diagnose acute appendicitis.

Keywords

Mathew John DJ, Babu DKNR. Accuracy indiagnosis of acute appendicitis by comparing serum C-reactive protein measurements and modified Alvarado score. IOSR Journal of Dental and Medical Sciences. 2016; 15(09):27–31. doi: 10.9790/0853-1509062731
Zinner M. Maingot’s abdominal operations. NewYork: McGraw Hill Professional; 2012.
Brunicardi F, Brandt M, Andersen D, Billiar T, Dunn D, Hunter J, et al. Schwartz’s principles of surgery ABSITE and board review.NewYork: McGraw Hill Professional; 2010.
Rezaei E, Ghaemei M, Motamdolshariatei M, Rashed T. [Accuracy of serum CRP measurement and WBC count in diagnosis of patients suspected to acute Appendicitis (Persian)]. Journal of Gorgan University of Medical Sciences. 2004; 6(2):83-86.
Yang HR, Wang YC, Chung PK, Chen WK, Jeng LB, Chen RJ. Role of leukocyte count, neutrophil percentage, and C-reactive protein in the diagnosis of acute appendicitis in the elderly. The American Surgeon. 2005; 71(4):344-7. PMID: 15943411
Shafi S, Malah M, Malah H, Reshi F. Evaluation of the modified Alvarado score incorporating the C-reactive protein in the patients with suspected acute appendicitis. Annals of Nigerian Medicine. 2011; 5(1):6-11. doi: 10.4103/0331-3131.84220
Bhopal FG, Ahmed B, Ahmed M, Ahmed M, Khan JS, Mehmood N, et al. Role of TLC and C-reactive protein in the diagnosis of acute appendicitis. Journal of Surgery Pakistan. 2003; 8(2):7-14.
Wu HP, Lin CY, Chang CF, Chang YJ, Huang CY. Predictive value of C-reactive protein at different cutoff levels in acute appendicitis. The American Journal of Emergency Medicine. 2005; 23(4):449-53. PMID: 16032609
Andersson REB. Meta-analysis of the clinical and laboratory diagnosis of appendicitis. British Journal of Surgery. 2004; 91(1):28–37. doi: 10.1002/bjs.4464
Grönroos JM. Do normal leucocyte count and C-reactive protein value exclude acute appendicitis in children? Acta Paediatrica. 2001; 90(6):649–51. doi: 10.1080/08035250117900
Tepel J, Sommerfeld A, Klomp HJ, Kapischke M, Eggert A, Kremer B. Prospective evaluation of diagnostic modalities in suspected acute appendicitis. Langenbeck’s Archives of Surgery. 2003; 389(3):219–224. doi: 10.1007/s00423-003-0439-6
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? Journal of the Royal College of Surgeons of Edinburgh. 2000; 45(1):21-4. PMID: 10815376
Shakhatreh H. The accuracy of C-reactive protein in the diagnosis of acute appendicitis compared with that of clinical diagnosis. Medical Archives. 1999; 54(2):109-10. PMID: 10934841
Abdoulhosseini MR, Sohrabi MB, Kalhor S, Zolfaghari P, Yahyaei E. [Comparison of serum level of CRP and platelet in acute perforated and non- perforated appendicitis in Imam Hossein hospital of Shahroud in 2011 (Persian)]. Medical Sciences Journal of Islamic Azad University,Tehran Medical Branch. 2013; 23(3):212-15.