Eosinophils and C-reactive protein are diagnostic and severity markers in acute appendicitis

Abstract

Introduction: Inflammatory parameters have been used in the diagnosis, prognosis and monitoring of various diseases. The objective of this study is to evaluate the white blood cells changes, platelets and C-reactive protein (CRP) and their correlation with the diagnosis and severity of acute appendicitis (AA). Methods: A retrospective study of patients undergoing appendectomy in 2011. It was recorded age, gender, length of hospital stay, the last laboratorial results obtained before the appendectomy (white blood cells count, platelets and CRP) and the histological analysis of the specimen. Results: 214 patients were submitted to appendectomy, 93 women and 121 men, age (median (Q1-Q3)) 30.0 years-old (21.0-41.5). 10.3% didn’t present acute appendicitis, 68.7% had acute phlegmonous appendicitis and 21.0% had acute gangrenous appendicitis. Between these groups, lymphocyte and eosinophils count, the ratios platelets-to-lymphocytes, platelets-to-eosinophils, neutrophils-to-eosinophils, neutrophils-to-lymphocytes and CRP presented statistically significant only in gangrenous appendicitis after the application of the Bonferroni’s correction. In AA (independently of the histological classification), the eosinophil count was significantly reduced 4.0x109/L (1.0 – 10.8) versus 7.5x109/L (4.0 – 17.8) and the CRP increased 3.4mg/dL (0.9 – 9.7) versus 2.1mg/dL (0.4 – 4.4), compared to normal appendix. Conclusion: The eosinophil count and the CRP presented as potential diagnostic and severity markers of acute appendicitis. However, more studies are needed to confirm these results.