Key result
Normal leucocyte count and C-reactive protein values do not effectively exclude acute appendicitis in children, as 7% of patients with acute appendicitis had normal values for both.
Why the study?
Do normal leucocyte count and C-reactive protein values exclude acute appendicitis in children?
Observational (n=200)
Do normal leucocyte count and C-reactive protein values exclude acute appendicitis in children?
Contrary to adult patients, normal leucocyte count and CRP values do not effectively exclude acute appendicitis in children.
Answers are grounded in this paper and cite their sources.
Normal leucocyte count and CRP may not exclude appendicitis in children; challenges adult consensus and leaves open pediatric-specific validation.
UNLABELLED: The present study aimed to determine the role of leucocyte count and C-reactive protein (CRP) measurements in the diagnosis of acute appendicitis in children. In particular, children with acute appendicitis but normal leucocyte count and CRP level were sought. The present study protocol was identical to those used in earlier studies on adult patients with suspected acute appendicitis. The mean preoperative leucocyte count and CRP value in 100 consecutive children with an uninflamed appendix at appendicectomy (group A) and in 100 consecutive patients with acute appendicitis (group B) were calculated. The numbers of patients with (i) both values normal, (ii) only leucocyte count raised, (iii) only CRP level raised, and (iv) both values raised were calculated in both groups A and B. Leucocyte count effectively (p < 0.001) separated children with uninflamed appendix (mean +/- SEM 10.2 +/- 0.4 x 10(9) l(-1)) from those with acute appendicitis (15.0 +/- 0.4 x 10(9) l(-1)), but the CRP value was of no use in this respect (p = 0.866; 31 +/- 4 mg l(-1) and 30 +/- 4 mg l(-1)). The most conspicuous finding was that in children with acute appendicitis, both values were normal in 7 out of 100 patients. CONCLUSION: Contrary to adult patients, normal leucocyte count and CRP value do not effectively exclude acute appendicitis in children.
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J M Grönroos (2001) conducted an observational in Acute appendicitis (n=200). Leucocyte count and C-reactive protein (CRP) measurement vs. Uninflamed appendix was evaluated on Mean preoperative leucocyte count (x 10^9 l^-1) (p=<0.001). Normal leucocyte count and C-reactive protein values do not effectively exclude acute appendicitis in children, as 7% of patients with acute appendicitis had normal values for both.
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