Predictive values of serum soluble CD40 ligand in acute appendicitis in children

Appendicitis is one of the most common abdominal emergencies in children. Clinicians cannot easily distinguish between non-perforated and perforated appendicitis in children through physical and laboratory tests. An abdominal computed tomography is a common tool for diagnosis. However, excessive radiation exposure is not suitable for children. Serum soluble CD40 ligand (sCD40L) is an inflammatory biomarker. The purpose of our study was to predict pediatric appendicitis and perforated appendicitis using sCD40L. All pediatric patients with suspected appendicitis were tested for serum sCD40L within 72 h of the symptom onset. sCD40L levels were compared between patients with a normal appendix, appendicitis, and a perforated appendicitis. The diagnostic performance of sCD40L was calculated, and receiver operating characteristic curves were drawn. Of 116 patients, 62 had non-perforated appendicitis, 44 had perforated appendicitis, and 10 had normal appendices. The sensitivity of sCD40L in predicting appendicitis was 1.00, while the specificity in predicting perforation was 1.00. The best cutoff point was found to be 178.00 pg/ml for predicting appendicitis and 308.26 pg/ml for perforation. SCD40L is an excellent predictor of pediatric appendicitis. sCD40L below 90.04 pg/ml can rule out appendicitis and above 301.00 pg/ml can rule in appendicitis.