Evaluation of Serum CRP, Procalcitonin and WBC in the Diagnosis of Acute Appendicitis

Introduction & For evaluation of laboratory data in the diagnosis of suspected acute appendicitis, many studies has been performed. In addition to White Blood Cell count (WBC) new laboratory variables such as C - reactive protein (CRP) and procalcitonin (PCT) have been introduced to help for a more definite evaluation. But, the findings are different and uncertain. The sensitivity and specificity of these variables are important for better diagnosis and in this study were assessed. A prospective cross-sectional study was done, which included 100 suspected patients with acute appendicitis who were admitted to a university hospital. After clinical evaluation and physical examination, WBC, CRP and PCT were determined. Decision for operation was made according to Alvarado scaling. After appendectomy and according to the pathologist report the patients were divided into two groups, having acute appendicitis or normal appendix. The sensitivity and specificity of these tests were compared between the two groups. In the 100 cases involved, 71 patients were male and 29 were female. The mean age of patients was 28.01±12.68 year. After operation, it was established in pathologic evaluation that 83 patients had acute appendicitis (AA), and 17 patients had normal appendix (NA). As far as WBC (P= 0.001) and Alvarado Scaling (P= 0.006) were showed. There was a significant difference between the two groups. But there was no significant for CRP (P= 0.025) and PCT (P= 0.042). Sensitivity of WBC, CRP and PCT were 85.5%, 92.77% and 55.42% respectively. Also, the specificity of WBC, CRP and PCT was 41.17%, 11.76% and 29.41% respectively. In the diagnosis of acute appendicitis use of symptoms and signs and laboratory data is helpful, although CRP and PCT can also help us in diagnosis in difficult situation.