The role of hematological parameters in distinguishing acute appendicitis from lymphoid hyperplasia

One of the most misdiagnosed appendicular pathologies is lymphoid hyperplasia (LH) that can be managed con-servatively when identified early and is self-limiting. The aim of this retrospective study was to compare acute appendicitis (AA) with LH in terms of hematological parameters to determine whet...

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Bibliographic Details
Published in:Ulusal travma ve acil cerrahi dergisi = Turkish journal of trauma & emergency surgery : TJTES 2022-04, Vol.28 (4), p.434-439
Main Authors: Kaya, Ahmet, Karaman, Kerem, Aziret, Mehmet, Ercan, Metin, Köse, Elif, Kahraman, Yavuz Selim, Karacaer, Cengiz
Format: Article
Language:English
Subjects:
Acute Disease
Animals
Appendectomy
Appendicitis
Appendicitis - diagnosis
Appendicitis - surgery
Blood
Cattle
Erythrocytes
Female
Hematology
Humans
Hyperplasia
Hyperplasia - diagnosis
Lymphocytes
Male
Neutrophils
Original
Retrospective Studies
Sensitivity and Specificity
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Summary:One of the most misdiagnosed appendicular pathologies is lymphoid hyperplasia (LH) that can be managed con-servatively when identified early and is self-limiting. The aim of this retrospective study was to compare acute appendicitis (AA) with LH in terms of hematological parameters to determine whether there is a hematological predictor to distinguish the two diseases. Complete blood cell counts of patients with AA were compared with those having LH. One-hundred-ninety-five patients (118 male/77 female) underwent appendectomy. Histopathological examination re-vealed acute AA in 161 patients (82.6%), and negative appendectomy (NA) in 19 patients (9.7%). Of the NA specimens, 16 were LH (8.2%). Thirteen patients (6.7%) had AA with simultaneous LH. White blood cell count (p=0.030, neutrophil (p=0.009), neutrophil per-centage (p=0.009), and neutrophil/lymphocyte ratio (p=0.007) were significantly higher in AA whereas lymphocyte count (p=0.027), lymphocyte percentage (p=0.006) were significantly higher in LH. Multi logistic regression analysis revealed white blood cell count as the only independent predictor in distinguishing AA from LH with a 69.1% sensitivity, 80.0% specificity, 77.5% positive predictive value, and 72.1% negative predictive value. The cut-off value for white blood cell count was 11.3 Ku/L, and every one unit (1000/mm3) increase in white blood cell count raises the risk of AA by 1.24 times, while values below this value will increase the likelihood of LH. The most predictive complete blood count parameter in distinguishing LH from AA appears to be as white blood cell count.
ISSN:1306-696X
1307-7945
DOI:10.14744/tjtes.2020.69027