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Diagnostic performance of serum interleukin-6 in pediatric acute appendicitis: a systematic review

  • Meta-analysis
  • Published:
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Abstract

Background

Despite the radiological and analytical advances of the last decades, there is still a significant rate of diagnostic error in pediatric acute appendicitis. In recent years, multiple biomarkers have emerged as potential diagnostic tools. This study aimed to examine the diagnostic performance of serum interleukin-6 in pediatric acute appendicitis.

Methods

We conducted a systematic review of the literature that involved an extensive search in the main databases of medical bibliography (Medline, PubMed, Web of Science and SciELO). Two independent reviewers selected the relevant articles based on the previously defined inclusion and exclusion criteria. Methodological quality of the selected article was rated using the QUADAS2 index. Data extraction was performed by two independent reviewers.

Results

The research in the medical bibliography databases resulted in 68 articles. We removed 26 duplicates. Among the remaining 42 articles, we excluded 33 following the inclusion and exclusion criteria. Of the final 9 studies included in this review, 8 provided measured serum interleukin-6 values, and all of them reported significant differences between groups, but inconsistent results regarding sensitivity and specificity.

Conclusions

The diagnostic performance of interleukine-6 alone for the diagnosis of acute appendicitis in children is limited. The sensitivity and specificity of interleukine-6 for the diagnosis of non-complicated acute appendicitis in the pediatric population are moderate but increased in complicated appendicitis. There seems to be a direct relationship between serum level of interleukin-6 and the hours of evolution of abdominal pain in children with acute appendicitis. The increasingly widespread use of non-operative management of acute appendicitis warrants further exploration of the classificatory potential of this marker between complicated and uncomplicated appendicitis. We consider that this may be an avenue of research to explore in the future.

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Data availability

The data used to carry out this systematic review are available upon request from the review authors.

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Funding

This review did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors. None of the authors have external funding to declare. No financial or non-financial benefits have been received or will be received from any party related directly or indirectly to the subject of this article.

Author information

Authors and Affiliations

  1. Pediatric Surgery Department, Complejo Hospitalario de Navarra, Calle Irunlarrea 3, 31008, Pamplona, Navarra, Spain

    Javier Arredondo Montero, Carlos Bardají Pascual & Giuseppa Antona

  2. Pathology Department, Complejo Hospitalario de Navarra, Pamplona, Spain

    Mónica Bronte Anaut

  3. Cardiovascular Translational Research, Navarrabiomed (Miguel Servet Foundation), Complejo Hospitalario de Navarra (CHN), Universidad Pública de Navarra (UPNA), IdiSNA, Pamplona, Spain

    Natalia López-Andrés

  4. Department of Preventive Medicine and Public Health, Instituto de Investigación Sanitaria de Navarra (IdiSNA), University of Navarra, Pamplona, Spain

    Nerea Martín-Calvo

  5. CIBER Fisiopatología de la Obesidad y Nutrición (CIBERobn), Health Institute Carlos III, Madrid, Spain

    Nerea Martín-Calvo

Authors
  1. Javier Arredondo Montero
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  2. Carlos Bardají Pascual
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  4. Natalia López-Andrés
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  5. Giuseppa Antona
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  6. Nerea Martín-Calvo
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Contributions

JAM conceptualization and study design; literature search and selection, data curation and extraction, formal analysis; investigation; methodology; project administration; resources; validation; visualization; writing—original draft; writing—review and editing. CBP literature search and selection, data curation and extraction, formal analysis; investigation; writing—original draft. MBA literature search and selection, data curation and extraction, formal analysis; investigation; writing—original draft. NLA literature search and selection, data curation and extraction, formal analysis; investigation; writing—original draft. GA literature search and selection, data curation and extraction, formal analysis; investigation; writing—original draft. NMC conceptualization and study design; literature search and selection, data curation and extraction, formal analysis; investigation; methodology; project administration; resources; validation; visualization; writing—original draft; writing—review and editing.

Corresponding author

Correspondence to Javier Arredondo Montero.

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The authors declare that they have no conflict of interest.

Ethical approval

This study did not involve the participation of human or animal subjects, and therefore was exempt from formal assessment by the ethics committee for clinical research of our center.

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Arredondo Montero, J., Bardají Pascual, C., Bronte Anaut, M. et al. Diagnostic performance of serum interleukin-6 in pediatric acute appendicitis: a systematic review. World J Pediatr 18, 91–99 (2022). https://doi.org/10.1007/s12519-021-00488-z

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  • DOI: https://doi.org/10.1007/s12519-021-00488-z

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