Appendicitis may be diagnosed in a timely manner?
Appendicitis, one of the most common surgical emergency in childhood, could be diagnosed early by detecting a protein in urine, considered by researchers at the Center for Pediatric Hospital proteomics in Boston, as biomarker for this disease.
Despite the evolution of diagnostic imaging techniques, recent studies show that between 3 and 30% of children suffer unnecessary surgeries for appendicitis, while 30-45% of those who has appendicitis are operated in the last minute.While diagnosis is mainly clinical, still,physicians have sought more accurate laboratory methods to determine whether or not a patient has appendicitis.
Researchers led by Dr. Richard Bachur, head of the Emergency Hospital in Boston, decided to undertake a systematic approach and have performed a proteomic study to identify the most accurate biomarker for appendicitis.In a first phase, they examined 12 samples of urine - 6 from patients with appendicitis, collected before and after surgery for appendicitis, and 6 from patients without appendicitis - identifying 32 substances that have been used as biomarkers. To these were joined other substances, identified by other means, such as studies of gene expression, reaching a total of 57 possible candidates.
In a later stage, researchers have attempted to validate biomarkers' usefulness in 67 children who were suspected of appendicitis, of which 25, diagnosis came true . The most accurate biomarker has proved leucine rich alpha 2 glycoprotein. Increased levels of this protein can be detected by immunoblotting, which justifies the researchers' hope to develop a rapid diagnostic test.
Results of investigations are published in an issue of the journal "Annals of Emergency Medicine".