Javier Arredondo Montero1, Carlos Bardají Pascual2, Mónica Bronte Anaut3, Natalia López-Andrés4, Giuseppa Antona2, Nerea Martín-Calvo5,6. 1. Pediatric Surgery Department, Complejo Hospitalario de Navarra, Calle Irunlarrea 3, 31008, Pamplona, Navarra, Spain. Javier.montero.arredondo@gmail.com. 2. Pediatric Surgery Department, Complejo Hospitalario de Navarra, Calle Irunlarrea 3, 31008, Pamplona, Navarra, Spain. 3. Pathology Department, Complejo Hospitalario de Navarra, Pamplona, Spain. 4. Cardiovascular Translational Research, Navarrabiomed (Miguel Servet Foundation), Complejo Hospitalario de Navarra (CHN), Universidad Pública de Navarra (UPNA), IdiSNA, Pamplona, Spain. 5. Department of Preventive Medicine and Public Health, Instituto de Investigación Sanitaria de Navarra (IdiSNA), University of Navarra, Pamplona, Spain. 6. CIBER Fisiopatología de la Obesidad y Nutrición (CIBERobn), Health Institute Carlos III, Madrid, Spain.
Abstract
BACKGROUND: Despite the radiological and analytical advances of the last decades, there is still a significant rate of diagnostic error in pediatric acute appendicitis. In recent years, multiple biomarkers have emerged as potential diagnostic tools. This study aimed to examine the diagnostic performance of serum interleukin-6 in pediatric acute appendicitis. METHODS: We conducted a systematic review of the literature that involved an extensive search in the main databases of medical bibliography (Medline, PubMed, Web of Science and SciELO). Two independent reviewers selected the relevant articles based on the previously defined inclusion and exclusion criteria. Methodological quality of the selected article was rated using the QUADAS2 index. Data extraction was performed by two independent reviewers. RESULTS: The research in the medical bibliography databases resulted in 68 articles. We removed 26 duplicates. Among the remaining 42 articles, we excluded 33 following the inclusion and exclusion criteria. Of the final 9 studies included in this review, 8 provided measured serum interleukin-6 values, and all of them reported significant differences between groups, but inconsistent results regarding sensitivity and specificity. CONCLUSIONS: The diagnostic performance of interleukine-6 alone for the diagnosis of acute appendicitis in children is limited. The sensitivity and specificity of interleukine-6 for the diagnosis of non-complicated acute appendicitis in the pediatric population are moderate but increased in complicated appendicitis. There seems to be a direct relationship between serum level of interleukin-6 and the hours of evolution of abdominal pain in children with acute appendicitis. The increasingly widespread use of non-operative management of acute appendicitis warrants further exploration of the classificatory potential of this marker between complicated and uncomplicated appendicitis. We consider that this may be an avenue of research to explore in the future.
BACKGROUND: Despite the radiological and analytical advances of the last decades, there is still a significant rate of diagnostic error in pediatric acute appendicitis. In recent years, multiple biomarkers have emerged as potential diagnostic tools. This study aimed to examine the diagnostic performance of serum interleukin-6 in pediatric acute appendicitis. METHODS: We conducted a systematic review of the literature that involved an extensive search in the main databases of medical bibliography (Medline, PubMed, Web of Science and SciELO). Two independent reviewers selected the relevant articles based on the previously defined inclusion and exclusion criteria. Methodological quality of the selected article was rated using the QUADAS2 index. Data extraction was performed by two independent reviewers. RESULTS: The research in the medical bibliography databases resulted in 68 articles. We removed 26 duplicates. Among the remaining 42 articles, we excluded 33 following the inclusion and exclusion criteria. Of the final 9 studies included in this review, 8 provided measured serum interleukin-6 values, and all of them reported significant differences between groups, but inconsistent results regarding sensitivity and specificity. CONCLUSIONS: The diagnostic performance of interleukine-6 alone for the diagnosis of acute appendicitis in children is limited. The sensitivity and specificity of interleukine-6 for the diagnosis of non-complicated acute appendicitis in the pediatric population are moderate but increased in complicated appendicitis. There seems to be a direct relationship between serum level of interleukin-6 and the hours of evolution of abdominal pain in children with acute appendicitis. The increasingly widespread use of non-operative management of acute appendicitis warrants further exploration of the classificatory potential of this marker between complicated and uncomplicated appendicitis. We consider that this may be an avenue of research to explore in the future.
Authors: J V Castell; M J Gómez-Lechón; M David; T Andus; T Geiger; R Trullenque; R Fabra; P C Heinrich Journal: FEBS Lett Date: 1989-01-02 Impact factor: 4.124
Authors: Fernando A Rivera-Chavez; Herbert Wheeler; Guy Lindberg; Robert S Munford; Grant E O'Keefe Journal: Ann Surg Date: 2003-03 Impact factor: 12.969
Authors: C Delgado-Miguel; A J Muñoz-Serrano; S Barrena Delfa; V Núñez Cerezo; K Estefanía; M Velayos; J Serradilla; L Martínez Martínez Journal: Cir Pediatr Date: 2019-10-01