Evaluation of the effectiveness of using leucocyte indices in the differential diagnosis of acuteabdominal pain in children in the fi rst 6 years of life
GASTROENTEROLOGY AND DIETOLOGY
Abstract
Evaluation of diagnostic efficiency of leukocyte indices in differential diagnostics of acute abdominal pain in children under 6 years of age, with identification of the most informative indicators, is a highly relevant task of modern pediatrics. The solution to this problem can significantly improve the accuracy of diagnostics, reduce the incidence of complications and optimize patient management tactics.The aim— to evaluate the efficiency of integral leukocyte indices in differential diagnostics of acute abdominal pain in children of the first 6 years of life.Materials and methods.A retrospective cohort study of 130 children was conducted (acute appendicitis n=35; functional bowel disorders: n=40; control: n=55). Based on the general blood test data, 13 integral leukocyte indices were calculated. Statistical analysis was performed using nonparametric methods.Results.High differential potential was revealed for the following indices: erythrocyte loading coefficient (0.88±0.76 conventional units for acute appendicitis, compared with 0.53±0.33 conventional units for functional bowel disorders; p=0.006), immunolymphocytic potential (147.41±177.87 conventional units for acute appendicitis, compared with 287.21±272.83 conventional units for functional bowel disorders; p <0.001), leukocyte intoxication index (4.84±5.58 conventional units for acute appendicitis, compared with 0.86±1.29 conventional units for functional bowel disorders; p <0.0001), modified leukocyte intoxication index (4.32±3.24 conventional units for acute appendicitis, compared with 3.27±2.57 conventional units for functional bowel disorders; p <0.01), reactive neutrophil response (15.54±13.07 conventional units in acute appendicitis compared to 9.21±15.36 conventional units in functional bowel disorders; p >0.05), body resistance index (5.82±9.69 conventional units in acute appendicitis, compared to 33.59±13.66 conventional units in functional bowel disorders; p <0.001), lymphocyte-granulocyte index (2.45±3.31 conventional units in acute appendicitis, compared to 5.72±7.98 in functional bowel disorders; p <0.05). Moderate value was noted for blood leukocyte shift index and Krebs index, but with limitations. Low significance was revealed for cell-phagocytic potential, leukocyte ratio and erythrocyte sedimentation rate, nuclear index of endotoxicosis — no significant differences, for allergic predisposition of the body — nonspecificity.Conclusions.The combination of erythrocyte loading coefficient, immunolymphocytic potential, leukocyte intoxication index, modified leukocyte intoxication index, body resistance index, blood leukocyte shift index, lymphocyte-granulocyte index demonstrated the greatest potential for differential diagnosis of acute appendicitis and functional bowel disorders in children under 6 years of age. Validation on an independent cohort and clarification of threshold values are necessary for implementation in clinical practice.
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