Serum ischemia-modified albumin and solubl urokinase plasminogen activator receptor levels in the diagnosis of acute appendicitis in children

Introduction and Objective: Acute appendicitis (AA) is the most common cause of abdominal pain in children that requires surgical intervention. The diagnosis of AA is based on the clinical, laboratory and imaging methods. Although the surgery is the traditionally preferred treatment, more sensitive biomarkers were needed in diagnosis with the emergence of non-operative therapy as an option. In our study, we aimed to investigate the use of blood IMA (ischemia-modified albumin) and suPAR (solubl urokinase plasminogen activator receptor) levels in the diagnosis of AA and distinguishing simple and complex appendicitis. Materials and Methods: The study included 57 pediatric patients and 63 healthy controls between the ages of 3 and 18. Patients were diagnosed with AA based on blood tests and abdominal USG, underwent surgery. AA group was stratified into simple and complex groups. IMA and suPAR levels were compared between the groups of patients with AA and the control group, and between the groups of patients with complex appendicitis and simple appendicitis. Thus, the association of IMA and suPAR with clinical, laboratory and imaging was investigated. Also, sensitivity and specificity of IMA and suPAR were calculated. Results: IMA and suPAR levels in children were significantly higher in AA group compared to control group, while they were similar in simple and complex appendicitis groups. In AA group, suPAR was positively correlated with procalcitonin (Pct) and negatively correlated with eosinophil count and albumin. In AA group, the suPAR was affected by pediatric appendicitis score, hs-CRP, Pct, erythrocyte sedimentation rate and monocyte. The predictive parameters for AA risk were age, hs-CRP, mean platelet volume, sodium, and IMA. The predictive parameters for complicated appendicitis risk were age, monocyte, platelet and IMA levels. Sensitivity and specificity of IMA and suPAR were low for AA. Conclusion: Although IMA and suPAR levels were high in children with acute appendicitis, their sensitivity and specificity were low for AA.