Determination of Pentraxin 3 Levels in Diagnosis of Appendicitis in Children

Background: The aim of this study is to determine whether pentraxin 3 (PTX3) levels can be used in the diagnosis of appendicitis in children.

Methods: Fifteen children under 18 years old, who gave blood samples for reasons other than inflammatory conditions, and 40 children who were proved to have appendicitis (non-perforated or perforated) between August 2017 and January 2018, were enrolled in the study. Patients were classified into subgroups: group 1 (healthy children without any sign of inflammation, n = 15), group 2 (non-perforated appendicitis, n = 25), and group 3 (perforated appendicitis, n = 15).

Results: The median PTX3 value was 1.01 ng/mL (minimum value: 0.82, maximum: 1.28) in the control group. The median PTX3 values prior to surgery were 20.68 ng/mL (minimum: 1.02, maximum: 28.471) and 1.46 (minimum: 1.05, maximum: 23.421) ng/mL for non-perforated appendicitis and perforated appendicitis respectively. The PTX3 levels were significantly higher in groups 2 and 3 than in group 1 (P < 0.01). According to receiver operating characteristics analysis the cut-off value of PTX3 levels at admission for appendicitis was 1.30 ng/mL with a sensitivity of 75% and a specificity of 100% (area under the curve, 0.939; P = 0.000).

Conclusions: Pentraxin 3 levels were significantly higher in children with appendicitis than in healthy children. Children with high PTX3 levels complaining of right lower quadrant pain may support a diagnosis of appendicitis. Future studies should be conducted to evaluate changes in PTX3 levels by comparing children with appendicitis versus acute abdominal pain in larger populations to further determine the value of PTX3 in the diagnosis of appendicitis in children.