Mohammad Hossein Sarmast Shoshtari, Shahnam Askarpour, Mansoor Alamshah, Ahmed Elahi.
Diagnostic value of quantitative CRP measurement in patients with acute appendicitis.
Pak J Med Sci Jan ;22(3):300-3.

Background: Acute appendicitis is one of the most common surgical emergencies. Main stay of diagnosis of acute appendicitis is accurate history, clinical evaluation and physical examination. It is further reinforced by laboratory investigation like raised leukocytes count. To avoid unnecessary removal of normal appendices more laboratory tests like C-Reactive Proteins (CRP) have been evolved. Methods: This is a prospective and cognitive study from January to June 2004 of all those patients who had appendectomies at the Golestan and Imam Khomeini Hospital of Medical University, Jundi-Shapour, Ahwaz. Results: Out of a total of 98 patients, on histological examination 88 (89.7%) had acute appendicitis whereas 15 (10.3%) were normal with no sign of inflammation. Range of CRP varied between 3.8 to 19.5 mg/1 (mean 6.34 mg/1), in patients with normal appendix and between 3.8 to 468.5 mg/1 (mean 49 mg/1), in patients with simple appendicitis and 30.1-408 mg/1 mean (113/2) in patients with complicated appendicitis. Normal CRP range of CRP was noted in 9 patients with acute appendicitis, and in 8 cases with normal appendectomy. Conclusions: Positive predictive value of CRP was 97.5%, specificity 89.7% sensitivity 80% and accuracy 88.7% Raised value of CRP was directly related to the severity of inflammation (p-value<0.05). Taken in conjunction with leukocyte count the diagnostic accuracy became more reliable. CRP monitoring enhances the diagnostic accuracy of acute appendicitis thus unnecessary removal of normal appendices may be reduced to about half.

PakMediNet -Pakistan's largest Database of Pakistani Medical Journals - http://www.pakmedinet.com