title: Role of serum cytokines in acute appendicitis and acute mesenteric lymphadenitis among children.
abstract: OBJECTIVE
  The diagnostic role of serum cytokines depends on the etiology and pathogenesis of acute appendicitis (AA) and acute mesenteric lymphadenitis (AML). The aim of this study was to evaluate differences in cytokine levels between AA and AML.
  
  
  METHODS
  Data of 7- to 18-year-old children were collected prospectively from October 2010 to October 2013. There were 31 patients with AA (AA group), 26 with AML (AML group), and 17 with elective non-inflammatory surgical disease (control group). Serum levels of IL-10, IL-12(p70), IL-1β, IL-4, IL-6, IL-8, IL-17, MCP-1, EGF, TNF-α and white blood count (WBC) were measured three times consecutively in each group.
  
  
  RESULTS
  The level of IL-6 and IL-10 was significantly higher in the AA group than the AML group at the first measurement (8pg/mL vs. 3.2pg/mL, P=0.000; 6.1pg/mL vs. 3.2pg/mL, P=0.005, respectively). There was a significant difference observed in time dynamics of concentration of IL-6 and MCP-1 for AA and AML. The area under the curve (AUC) was 0.77 (95% CI 0.64-0.89; P=0.001) for IL-6 with a cut-off value of 4.3pg/mL (67.7% sensitivity and 76.9% specificity) for AA 1h before surgery. The AUC for WBC was 0.72 (95% CI 0.58.4-0.85; P=0.005) with a cut-off value of 10.7×103/μL (sensitivity 71.0% and specificity 46.2%).
  
  
  CONCLUSIONS
  Serum IL-6 with a cut-off value of 4.3pg/mL and WBC with a cut-off value of 10.7×103/μL assessed together will yield more sensitivity for AA.
authors: Department of Pediatric Surgery, University Children's Hospital, Riga, Latvia. Electronic address: astrazviedre@inbox.lv.
authors: Astra
authors: A
authors: Zviedre
authors: Department of Pediatric Surgery, University Children's Hospital, Riga, Latvia; Department of Pediatric Surgery, Riga Stradiņš University, Riga, Latvia.
authors: Arnis
authors: A
authors: Engelis
authors: Department of Physiology and Biochemistry, Riga Stradiņš University, Riga, Latvia.
authors: Peteris
authors: P
authors: Tretjakovs
authors: Department of Physiology and Biochemistry, Riga Stradiņš University, Riga, Latvia.
authors: Antra
authors: A
authors: Jurka
authors: Department of Research, Statistics and Health Promotion, Centre for Disease Prevention and Control of Latvia, Riga, Latvia; Department of Public Health and Epidemiology, Riga Stradiņš University, Riga, Latvia.
authors: Irisa
authors: I
authors: Zile
authors: Department of Pediatric Surgery, University Children's Hospital, Riga, Latvia; Department of Pediatric Surgery, Riga Stradiņš University, Riga, Latvia.
authors: Aigars
authors: A
authors: Petersons
mesh_terms: D000208:Acute Disease; D000293:Adolescent; D001064:Appendicitis / Q000097:blood / Q000175:diagnosis* / Q000601:surgery; D015415:Biomarkers / Q000097:blood; D016022:Case-Control Studies; D002648:Child; D016207:Cytokines / Q000097:blood*; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D007958:Leukocyte Count; D008297:Male; D008640:Mesenteric Lymphadenitis / Q000097:blood / Q000175:diagnosis* / Q000601:surgery; D011446:Prospective Studies; D012680:Sensitivity and Specificity; D013997:Time Factors
chemical_list: D015415:Biomarkers; D016207:Cytokines
keywords: Appendicitis; Children; Cytokines; Mesenteric lymphadenitis