Registration number: 2013-01888Title:The role of Mean Platelet Volume (MPV) in the diagnosis of acute appendicitis inchildren and adolescentsIntroduction:A case, presenting with signs and symptoms of acute appendicitis pushes the clinician into thedilemma as the diagnosis of acute appendicitis is still complicated and problematic. Delay indiagnosis may lead to perforation even just after 24 hours of onset of pain followed by itscomplication and temporary relief from pain. On the contrary the incidences of negativeappendectomy rates are as high as 40-50% in young children, geriatric patients and in adolescentfemales. But unfortunately the clinical history, physical examination and laboratory tests donot provide the sufficient data to arrive at an accurate diagnosis especially in children.Eventhough ultrasonography and computerized tomography give promising data they are notsufficient.[2-3]Thus there is the need for a diagnostic tool which would be applicable everywhere,be cheap, noninvasive, and less time consuming but be able to distinguish nonspecific abdominalpain from acute appendicitis. In this direction many studies have been carried out regardinginflammatory mediators’ diagnostic value in acute appendicitis. In the clinics one of thelaboratory parameters considered generally is WBC count. However the WBC counts and thelevel of inflammatory mediators remain nearly unaltered in early cases of acute appendicitiswhich has not gone to the extent of perforation.Mean Platelet Volume(MPV) is known to be a marker determined from megakaryocytes and isassociated with platelet function and activation. MPV is a general hematological parametercalculated routinely during blood counts to which clinicians don’t pay the attention eventhough it
might act as a marker of inflammation. The studies which have been carried out on diagnosticrole of MPV in the case of adult acute appendicitis is conflicting.[4-5]In this study we aim toinvestigate the diagnostic role of the mean platelet volume in acute appendicitis in children andadolescents.Objective:The aim of the present study is to evaluate the diagnostic value of Mean PlateletVolume(MPV) in acute appendicitis in children and adolescents.Methodology:STUDY TYPE : RetrospectiveINCLUSION CRITERIA FOR GROUP ‘T’: Present research involves thestudy of the 50 patientsbelow the age of 18 years chosen retrospectively from the case files in whom the definitediagnoses should have been confirmed with post operative pathological examination. This groupwill be called Test(T) group.Exclusion criteria for group ‘T’: Patients who are suffering from bleeding disorders, othergenetic disorders and any other infections.The healthy Control group will be the patients bellow the age of 18 years who have no heartfailure, peripheral vascular disease, acute or chronic infections, liver disease.Statistical analysis: The descriptive statistics for the studied variables will be presented as meandeviation, standard deviation. The quantitative data will be analyzed by independent ‘t’ test.
Implications:1. The relation between the MPV and acute appendicitis will be established and hence itsdiagnostic value in diagnosis of acute appendicitis in children and adolescent will beexplored.2. On considering the MPV as the diagnostic tool with other parameters and clinicalexaminations the negative appendectomy rates in children and adolescents with suspectedacute appendicitis may come down.3. The dilemma in the diagnosis of acute appendicitis in children and adolescents may beovercome and the rate of perforation and further complications may be reduced.References:1. Andersson RE, Hugander A, Thulin AJ. Diagnostic accuracy and perforation rate inappendicitis: association with age and sex of the patient and with appendicectomy rate.Eur J Surg. 1992;158:37-41.2. Lessin MS, Chan M, Catallozzi M, Gilchrist MF, Richards C, Manera L et al. Selectiveuse of ultrasonography for acute appendicitis in children. Am J Surg. 1999;177:193-6.3. Andersson M, Andersson RE.The appendicitis inflammatory response score: a tool forthe diagnosis of acute appendicitis that outperforms the Alvarado score.World J Surg.2008;32:1843-9.4. Bilici S, Sekmenli T, Göksu M, Melek M, Avci V. Mean platelet volume in diagnosis ofacute appendicitis in children. Afr Health Sci. 2011;11:427-32.
5. Uyanik B, Kavalci C, Arslan ED, Yilmaz F, Aslan O, Dede S, Bakir F. Role of meanplatelet volume in diagnosis of childhood acute appendicitis. Emerg Med Int.2012;2012:823095.