Document Detail


Phospholipase A2, C-reactive protein, and white blood cell count in the diagnosis of acute appendicitis.
MedLine Citation:
PMID:  8070088     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
We compared the predictive value of determining group II phospholipase A2 (PLA2) in serum for diagnosing acute appendicitis with the predictive values of white blood cell count (WBC) and measurement of C-reactive protein (CRP). In this prospective study, we included 186 patients who were undergoing appendectomy after clinical diagnoses of acute appendicitis. The performance of each test was measured by receiver-operating characteristic curves. WBC was the test of choice in diagnosing uncomplicated acute appendicitis. However, in contrast to CRP and PLA2, which increased in patients with protracted inflammation, there was not a concomitant increase in WBC. Therefore, especially CRP, but also PLA2, were better indicators of appendiceal perforation or abscess formation than was WBC. Increased WBC, CRP, and PLA2 values did not unequivocally corroborate the clinical suspicion of appendicitis, but if all three values were within normal limits, acute appendicitis could be excluded with a 100% predictive value. PLA2 values showed a highly significant correlation with CRP but not with WBC values, which supports the view that PLA2 represents an acute-phase reactant.
Authors:
J M Grönroos; J J Forsström; K Irjala; T J Nevalainen
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Clinical chemistry     Volume:  40     ISSN:  0009-9147     ISO Abbreviation:  Clin. Chem.     Publication Date:  1994 Sep 
Date Detail:
Created Date:  1994-09-29     Completed Date:  1994-09-29     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  9421549     Medline TA:  Clin Chem     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  1757-60     Citation Subset:  IM    
Affiliation:
Department of Surgery, University of Turku, Finland.
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MeSH Terms
Descriptor/Qualifier:
Acute Disease
Adolescent
Adult
Aged
Appendicitis / blood,  diagnosis*,  enzymology
C-Reactive Protein / metabolism*
Female
Humans
Leukocyte Count
Male
Middle Aged
Phospholipases A / metabolism*
Phospholipases A2
Predictive Value of Tests
Prospective Studies
Chemical
Reg. No./Substance:
9007-41-4/C-Reactive Protein; EC 3.1.1.-/Phospholipases A; EC 3.1.1.4/Phospholipases A2

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