Skip to main content

Advertisement

SpringerLink
Log in

Blood routine examination: a simple way for differential diagnosis of immunoglobulin A vasculitis with abdominal involvement and appendicitis in children

  • Original Article
  • Published:
Updates in Surgery Aims and scope Submit manuscript

Abstract

To explore the value of blood routine examination indexes in the differential diagnosis of immunoglobulin A vasculitis (IgAV) with abdominal involvement and appendicitis in children. Forty-seven patients with IgAV and abdominal involvement, 95 cases with appendicitis, and 48 healthy children were enrolled in this study. Demographic and laboratory data were retrospectively recorded from medical files. The levels of serum percentage of lymphocytes (LYM%), percentage of eosinophils (E%), red cell volume distribution width (RDW) and platelet (PLT) count were higher, while blood cells (WBC) count, percentage of neutrophils (N%), percentage of monocytes (M%), mean platelet volume (MPV), platelet distribution width and C-reactive protein were lower in the group of IgAV with abdominal involvement compared to appendicitis group (P < 0.05). Multivariate logistic regression analysis showed LYM% (odds ratio (OR) = 1.34, P = 0.001) and RDW (OR = 2.96, P = 0.045) were independent risk factors for IgAV with abdominal involvement. N% (OR = 1.270, P = 0.006) and MPV (OR = 51.15, P = 0.042) were independently associated with appendicitis. Using receiver operating characteristic analysis, the optimal cut-off values (sensitivity and specificity) respectively were 42.17% (95.7%, 100.0%) for LYM%, 12.65% (83.0%, 83.2%) for RDW, 61.5% (91.6%, 97.9%) for NE% and 10.1fL (78.9%, 75.4%) for MPV, with the AUC values of 0.989, 0.881, 0.985, 0.810, respectively. Blood routine examination indices, especially the N%, LYM%, RDW, and MPV, can be used for simple differential diagnosis of IgAV with abdominal involvement and appendicitis.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1

Similar content being viewed by others

Availability of data and materials

The datasets used and/or analyzed during the current study are available from the corresponding author on reasonable request.

References

  1. López-Mejías R, Castañeda S, Genre F et al (2018) Genetics of immunoglobulin-A vasculitis (Henoch-Schönlein purpura): an updated review. Autoimmun Rev 17:301–315. https://doi.org/10.1016/J.AUTREV.2017.11.024

    Article  PubMed  Google Scholar 

  2. Piram M, Maldini C, Biscardi S et al (2017) Incidence of IgA vasculitis in children estimated by four-source capture-recapture analysis: a population-based study. Rheumatology (Oxford) 56:1358–1366. https://doi.org/10.1093/rheumatology/kex158

    Article  Google Scholar 

  3. Ozen S, Pistorio A, Iusan SM et al (2010) EULAR/PRINTO/PRES criteria for Henoch-Schönlein purpura, childhood polyarteritis nodosa, childhood Wegener granulomatosis and childhood Takayasu arteritis: Ankara 2008. Part II: Final classification criteria. Ann Rheum Dis 69:798–806. https://doi.org/10.1136/ard.2009.116657

    Article  PubMed  Google Scholar 

  4. Trapani S, Rubino C, Indolfi G (2020) Gastrointestinal involvement in childhood vasculitides. Acta Paediatr 109:2226–2236. https://doi.org/10.1111/APA.15381

    Article  PubMed  Google Scholar 

  5. Rubino C, Monacelli C, Marrani E et al (2021) Gastrointestinal involvement in IgA vasculitis: a single-center 11-year study on a cohort of 118 children. Clin Rheumatol 40:5041–5046. https://doi.org/10.1007/S10067-021-05863-9

    Article  PubMed  Google Scholar 

  6. Anderson JE, Bickler SW, Chang DC, Talamini MA (2012) Examining a common disease with unknown etiology: trends in epidemiology and surgical management of appendicitis in California, 1995–2009. World J Surg 36:2787–2794. https://doi.org/10.1007/S00268-012-1749-Z

    Article  PubMed  Google Scholar 

  7. Glerum KM, Selbst SM, Parikh PD, Zonfrillo MR (2021) Pediatric Malpractice Claims in the Emergency Department and Urgent Care Settings From 2001 to 2015. Pediatr Emerg Care 37:E376–E379. https://doi.org/10.1097/PEC.0000000000001602

    Article  PubMed  Google Scholar 

  8. Baxter KJ, Nguyen HTMH, Wulkan ML, Raval MV (2018) Association of health care utilization with rates of perforated appendicitis in children 18 years or younger. JAMA Surg 153:544–550. https://doi.org/10.1001/JAMASURG.2017.5316

    Article  PubMed  PubMed Central  Google Scholar 

  9. Benabbas R, Hanna M, Shah J, Sinert R (2017) Diagnostic accuracy of history, physical examination, laboratory tests, and point-of-care ultrasound for pediatric acute appendicitis in the emergency department: a systematic review and meta-analysis. Acad Emerg Med Off J Soc Acad Emerg Med 24:523–551. https://doi.org/10.1111/ACEM.13181

    Article  Google Scholar 

  10. Bhangu A, Søreide K, di Saverio S, Assarsson HJ, Drake TF (2015) Acute appendicitis: modern understanding of pathogenesis, diagnosis, and management. Lancet (London, England) 386:1278–1287. https://doi.org/10.1016/S0140-6736(15)00275-5

    Article  Google Scholar 

  11. Choong CK, Beasley SW (1998) Intra-abdominal manifestations of Henoch-Schönlein purpura. J Paediatr Child Health 34:405–409. https://doi.org/10.1046/J.1440-1754.1998.00263.X

    Article  CAS  PubMed  Google Scholar 

  12. Karabulut R, Sonmez K, Turkyilmaz Z et al (2011) Negative appendectomy experience in children. Ir J Med Sci 180:55–58. https://doi.org/10.1007/S11845-010-0526-Y

    Article  CAS  PubMed  Google Scholar 

  13. Jaszczura M, Góra A, Grzywna-Rozenek E et al (2019) Analysis of neutrophil-to-lymphocyte ratio, platelet to lymphocyte ratio and mean platelet volume to platelet count ratio in children with acute stage of immunoglobulin A vasculitis and assessment of their suitability for predicting the course of the disease. Rheumatol Int 39:869–878. https://doi.org/10.1007/S00296-019-04274-Z

    Article  CAS  PubMed  Google Scholar 

  14. Peksöz R, Bayar B (2021) The role of complete blood count parameters in diagnosing acute appendicitis and measuring the severity of inflammation. Ulus Travma Acil Cerrahi Derg 27:654–661. https://doi.org/10.14744/TJTES.2020.69195

    Article  Google Scholar 

  15. Hajibandeh S, Hajibandeh S, Hobbs N, Mansour M (2020) Neutrophil-to-lymphocyte ratio predicts acute appendicitis and distinguishes between complicated and uncomplicated appendicitis: A systematic review and meta-analysis. Am J Surg 219:154–163. https://doi.org/10.1016/J.AMJSURG.2019.04.018

    Article  PubMed  Google Scholar 

  16. Dayawansa NH, Segan JDS, Yao HHI et al (2018) Incidence of normal white cell count and C-reactive protein in adults with acute appendicitis. ANZ J Surg 88:E539–E543. https://doi.org/10.1111/ANS.13760

    Article  PubMed  Google Scholar 

  17. Karadağ ŞG, Çakmak F, Çil B et al (2021) The relevance of practical laboratory markers in predicting gastrointestinal and renal involvement in children with Henoch-Schönlein Purpura. Postgrad Med 133:272–277. https://doi.org/10.1080/00325481.2020.1807161

    Article  CAS  PubMed  Google Scholar 

  18. Furer A, Finkelstein A, Halkin A et al (2015) High red blood cell distribution width and preclinical carotid atherosclerosis. Biomarkers 20:376–381. https://doi.org/10.3109/1354750X.2015.1096304

    Article  CAS  PubMed  Google Scholar 

  19. Wei J, Yang RX, Ye Q et al (2018) Higher risk of myocardial injury in chest pain patients with elevated red blood cell distribution width. Clin Chim Acta 481:121–125. https://doi.org/10.1016/J.CCA.2018.03.001

    Article  CAS  PubMed  Google Scholar 

  20. Huang YL, Hu ZD, Liu SJ, et al (2014) Prognostic value of red blood cell distribution width for patients with heart failure: a systematic review and meta-analysis of cohort studies. PLoS ONE 9:e104861. https://doi.org/10.1371/JOURNAL.PONE.0104861

  21. Li J, Li D-E, Hu M et al (2022) Red blood cell distribution width and tumor necrosis factor-α for the early prediction of coronary artery lesion in Kawasaki disease: a retrospective study. Eur J Pediatr 181:903–909. https://doi.org/10.1007/S00431-021-04252-3

    Article  PubMed  Google Scholar 

  22. Zhu X, Zhang M, Lan F et al (2018) The relationship between red cell distribution width and the risk of Henoch-Schönlein purpura nephritis. Br J Biomed Sci 75:30–35. https://doi.org/10.1080/09674845.2017.1368184

    Article  CAS  PubMed  Google Scholar 

  23. Xu H, Li W, Mao JH, Pan YX (2017) Association between red blood cell distribution width and Henoch-Schonlein purpura nephritis. Medicine 96:e7091. https://doi.org/10.1097/MD.0000000000007091

    Article  PubMed  PubMed Central  Google Scholar 

  24. Korniluk A, Koper-Lenkiewicz OM, Kamińska J et al (2019) Mean Platelet Volume (MPV): new perspectives for an old marker in the course and prognosis of inflammatory conditions. Mediators Inflamm 2019:9213074. https://doi.org/10.1155/2019/9213074

    Article  PubMed  PubMed Central  Google Scholar 

  25. Kaser A, Brandacher G, Steurer W et al (2001) Interleukin-6 stimulates thrombopoiesis through thrombopoietin: role in inflammatory thrombocytosis. Blood 98:2720–2725. https://doi.org/10.1182/BLOOD.V98.9.2720

    Article  CAS  PubMed  Google Scholar 

  26. Narci H, Turk E, Karagulle E et al (2013) The role of mean platelet volume in the diagnosis of acute appendicitis: a retrospective case-controlled study. Iran Red Crescent Med J 15:e11934. https://doi.org/10.5812/IRCMJ.11934

    Article  PubMed  PubMed Central  Google Scholar 

  27. Shen G, Li S, Shao Z et al (2021) Platelet indices in patients with acute appendicitis: a systematic review with meta-analysis. Updat Surg 73:1327–1341. https://doi.org/10.1007/S13304-020-00928-X

    Article  Google Scholar 

  28. Albayrak Y, Albayrak A, Albayrak F et al (2011) Mean platelet volume: a new predictor in confirming acute appendicitis diagnosis. Clin Appl Thromb 17:362–366. https://doi.org/10.1177/1076029610364520

    Article  Google Scholar 

  29. Uyanik B, Kavalci C, Arslan ED et al (2012) Role of mean platelet volume in diagnosis of childhood acute appendicitis. Emerg Med Int 2012:823095. https://doi.org/10.1155/2012/823095

  30. Chen Z, Lu Y, Wu J, Zhang H (2021) Clinical significance of blood platelets and mean platelet volume in patients with ulcerative colitis. J Int Med Res 49:1–9. https://doi.org/10.1177/03000605211009715

    Article  PubMed  PubMed Central  Google Scholar 

  31. Li B, Ren Q, Ling J et al (2021) Clinical relevance of neutrophil-to-lymphocyte ratio and mean platelet volume in pediatric Henoch-Schonlein Purpura: a meta-analysis. Bioengineered 12:286–295. https://doi.org/10.1080/21655979.2020.1865607

    Article  CAS  PubMed  PubMed Central  Google Scholar 

Download references

Acknowledgements

The author would like to thank Prof. Mizu Jiang and Prof. Yunguang Bao for their supports and encouragement for this article writing. The author also would like to thank doctor Xiaobing Li for his support for data collection. Xinyi Jia conceived the study and participated in its design, coordination, and data interpretation as well as review of the manuscript. Ting Yang, Jing Miao and Linqian Zhang carried out data acquisition and got involved in data interpretation as well as manuscript preparation. All authors read and approved the manuscript. We also would like to thank Editage (www.editage.cn) for English language editing.

Funding

No specific funding was received from public, commercials or organizations. The study was carried out for no profit.

Author information

Authors and Affiliations

  1. Gastrointestinal Lab, Children’s Hospital, Zhejiang University School of Medicine, National Clinical Research Center for Child Health, National Children’s Regional Medical Center, 3333 Bin Sheng Road, Hangzhou, 310052, Zhejiang, People’s Republic of China

    Xinyi Jia, Ting Yang, Jing Miao & Mizu Jiang

  2. Jinhua Hospital, Zhejiang University and Jinhua Municipal Central Hospital, Jinhua, Zhejiang, People’s Republic of China

    Xinyi Jia, Jing Miao, Linqian Zhang, Xiaobing Li & Yunguang Bao

  3. Pediatric Endoscopy Center and Department of Gastroenterology, Children’s Hospital, Zhejiang University School of Medicine, National Clinical Research Center for Child Health, National Children’s Regional Medical Center, 3333 Bin Sheng Road, Hangzhou, 310052, Zhejiang, People’s Republic of China

    Xinyi Jia & Mizu Jiang

Authors
  1. Xinyi Jia
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Ting Yang
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Jing Miao
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Linqian Zhang
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Xiaobing Li
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Yunguang Bao
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Mizu Jiang
    View author publications

    You can also search for this author in PubMed Google Scholar

Contributions

Xinyi Jia conceived the study and participated in its design, coordination, and data interpretation as well as review of the manuscript. Ting Yang, Jing Miao and Linqian Zhang carried out data acquisition and got involved in data interpretation as well as manuscript preparation. All authors read and approved the manuscript. Xiaobing Li and Yunguang Bao are responsible for checking the patient information and analyzing the rationality of the data. Mizu Jiang is responsible for article review and detail optimization.

Corresponding author

Correspondence to Mizu Jiang.

Ethics declarations

Conflict of interests

The authors have declared no conflicts of interest.

Ethics approval and consent to participate

This study was approved by the medical ethics committee of the Jinhua Municipal Central Hospital; written informed consent was obtained from parents.

Research involving human participants and/or animals and Informed consent

This study was approved by the Institutional Ethics Review Board for human studies at the Jinhua Municipal Central Hospital (Permission number: 2019-014-001), and written informed consent was obtained from the parents prior to the present study.

Additional information

Publisher's Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Jia, X., Yang, T., Miao, J. et al. Blood routine examination: a simple way for differential diagnosis of immunoglobulin A vasculitis with abdominal involvement and appendicitis in children. Updates Surg 74, 1683–1689 (2022). https://doi.org/10.1007/s13304-022-01299-1

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s13304-022-01299-1

Keywords

Search

Navigation