Diagnostic value of C- reactive protein and white blood count in patients with suspicious appendicitis

Background: Acute appendicitis is one of the most common causes of emergency surgeries, but sometimes the physicians face difficulties in proper diagnosis and management. Counting white blood cells and (CRP) C-reactive protein were important factors along with related clinical symptoms. The purpose of this study was evaluate the diagnostic value of these two factors in the diagnosis of acute appendicitis.

Methods: In this descriptive study patients with abdominal pain suspected of acute appendicitis were examined. In patients who received the results of clinical examinations and other diagnostic procedures (sonography, CT scan, etc.) to prove Acute appendicitis was ambiguous and non-determinant, and the score of Alvarado 6-4, a blood sample was taken for checking WBC, CRP and PMN, and was immediately sent to the lab. The laboratory kit used for the above measurements belonged to Bio System Reagents & Instrument Barcelona-Spain, and the sensitivity of this test was 0.15 mg / L according to the Bio System brochure. CRP>10 mg / L and PMN> 70%, WBC> 10000 / cu mm positive were considered.

Results: A total of 251 patients with appendicitis with mean age of 26.48 ± 10.5 years were studied. Alvaro criteria in patients with acute appendicitis 3.95 ± 0.22 and 4.9 ± 0.27 in patients with normal appendix (P = 0.5). The result of the pathology were normal in 102 (40.6%) cases, acute appendicitis in 91 cases (36.3%), and aphthous aphastics in 58 cases (23.1%). And, 88 (35.1%) patients had normal WBC and 163 (64.9%) cases had WBC levels more than 10,000 Cumm. Also, 50 patients (19.9%) had normal CRP but in 201 cases (80.1%) the CRP was higher than 10 mg/L. WBC had a sensitivity, specificity, positive predictive value, and negative predictive value of 69.12 %, 59%, 16.19% and 52.27%, respectively in diagnosis of acute appendicitis. CRP had a sensitivity, specificity, positive predictive value, and negative predictive value of 69.12 %, 59%, 16.19% and 52.27% respectively in diagnosis of acute appendicitis.

Conclusion: By measuring CRP and white blood cell count, a negative appendectomy can be reduced along with a clinical examination.