title: Plasma D-lactic acid level: a useful marker to distinguish perforated from acute simple appendicitis.
abstract: Early diagnosis of perforated appendicitis is important for reducing morbidity rates. The aim of this study was to determine the value and utility of plasma D-lactic acid levels in identifying the type of appendicitis. In this clinical study, plasma D-lactic acid levels were assessed in 44 consecutive paediatric patients (23 with acute appendicitis, 21 with perforated appendicitis) before laparotomy. D-lactic acid levels were determined by an enzymatic spectrophotometric technique using a D-lactic acid dehydrogenase kit. Patients with perforated appendicitis had higher D-lactic acid levels (3.970 +/- 0.687 mg/dL) than patients in the control group (0.478 +/- 0.149 mg/dL) and patients with acute appendicitis (1.409 +/- 0.324 mg/dL; p < 0.05). For a plasma D-lactic acid level greater than 2.5 mg/dL, the sensitivity and specificity of the D-lactic acid assay were 96% and 87%, respectively. The positive predictive value was 87%, the negative predictive value was 96%, and the diagnostic value was 91%. These results suggest that the measurement of plasma D-lactic acid levels may be a useful adjunct to clinical and radiological findings in distinguishing perforated from acute non-perforated appendicitis in children.
authors.affiliation: Department of Pediatric Surgery, Faculty of Medicine, Inonu University, Malatya, Turkey. mdemircan@inonu.edu.tr
authors.forename: Mehmet
authors.initials: M
authors.lastname: Demircan
authors.forename: Selma
authors.initials: S
authors.lastname: Cetin
authors.forename: Sema
authors.initials: S
authors.lastname: Uguralp
authors.forename: Nurzen
authors.initials: N
authors.lastname: Sezgin
authors.forename: Abdurrahman
authors.initials: A
authors.lastname: Karaman
authors.forename: Engin M
authors.initials: EM
authors.lastname: Gozukara
mesh_terms: D000208:Acute Disease; D001064:Appendicitis / Q000097:blood* / Q000175:diagnosis; D015415:Biomarkers / Q000097:blood; D002648:Child; D003937:Diagnosis, Differential; D006801:Humans; D007416:Intestinal Perforation / Q000097:blood* / Q000175:diagnosis; D019344:Lactic Acid / Q000097:blood*; D011237:Predictive Value of Tests; D012422:Rupture, Spontaneous
chemical_list: D015415:Biomarkers; D019344:Lactic Acid