Mean platelet volume, red cell distribution width, neutrophil to lymphocyte ratio and platelet to lymphocyte ratio in the diagnosis of acute appendicitis

Mean platelet volume (MPV), red cell distribution width (RDW), platelet to lymphocyte ratio (PLR) and neutrophil to lymphocyte ratio (NLR) have been seperately reported to be laboratory markers in several inflammatory diseases, including acute appendicitis. However, the results of these studies are conflicting. The aim of this study was to simultaneously investigate if MPV, RDW, PLR and NLR have a diagnostic role in the diagnosis of acute appendicitis and also the relationship between these systemic inflammation marker and leukocyte count. Thirty patients with acute appendicitis and 30 age-matched healthy subjects. RDW, MPV, neutrophils, lymphocytes and platelet counts were evaluated with complete blood count. The NLR and PLR were calculated as the ratios of the neutrophils and platelets to the lymphocytes. NLR and leukocyte count were significantly higher in the acute appendicitis patients compared to controls (both p<0.001), while RDW levels were significantly lower (p=0.041). There were no statistically significant differences regarding platelet numbers, MPV levels and PLR between acute appendicitis and healthy subjects (All; p>0.05). There was a significant correlation between leukocyte count and NLR (p<0.01, r=0.365). However, leukocyte count was not correlated with RDW and MPV levels (all; p>0.05). The current study is the first to investigate MPV, RDW, PLR and NLR in acute appendicitis patients. We found significantly increased NLR and leukocyte count in acute appendicitis patients compared to healthy subjects. Combined use of NLR and RDW values along with leukocyte count and other clinical assessment could help the diagnostic process of acute appendicitis.

___

1. Andersson RE. Meta-analysis of the clinical and laboratory diagnosis of appendicitis. Br J Surg 2004; 91: 28-37.

2. Karagulle E, Turk E, Ezer A, et al. Value of Plasma Viscosity in Acute Appendicitis: a Preliminary Study. J Med Med Sci 2010; 1: 423- 425.

3. Graff L, Russell J, Seashore J, et al. Falsenegative and false-positive errors in abdominal pain evaluation: failure to diagnose acute appendicitis and unnecessary surgery. Acad Emerg Med 2000; 7: 1244-1255.

4. Orr RK, Porter D, Hartman D. Ultrasonography to evaluate adults for appendicitis: decision making based on meta-analysis and probabilistic

reasoning. Acad Emerg Med 1995; 2: 644-650. 5. Lessin MS, Chan M, Catallozzi M, et al. Selective use of ultrasonography for acute appendicitisin children. Am J Surg 1999; 177: 193-196.

6. Park Y, Schoene N, Harris W. Mean platelet volume as an indicator of platelet activation: methodological issues. Platelets 2002; 13: 301- 306.

7. Thompson CB, Jakubowski JA, Quinn PG, Deykin D, Valeri CR. Platelet size as a determinant of platelet function. J Lab Clin Med 1983; 101: 205-213.

8. Tanrikulu CS, Tanrikulu Y, Sabuncuoglu MZ, et al. Mean platelet volume and red cell distribution width as a diagnostic marker in acute appendicitis. Iran Red Crescent Med J 2014; 16: e10211.

9. Uyanik B, Kavalci C, Arslan ED, et al. Role of mean platelet volume in diagnosis of childhood acute appendicitis. Emerg Med Int 2012; 2012: 823095.

10. Bilici S, Sekmenli T, Göksu M, Melek M, Avci V. Mean platelet volume in diagnosis of acute appendicitis in children. Afr Health Sci 2011; 11: 427-432.

11. Erdem H, Aktimur R, Cetinkunar S, et al. Evaluation of mean platelet volume as adiagnostic biomarker in acute appendicitis. Int J Clin Exp Med 2015; 8: 1291-1295.

12. Oztürk ZA, Unal A, Yigiter R, et al. Is increased red cell distribution width (RDW) indicating the inflammation in Alzheimer's disease (AD)? Arch Gerontol Geriatr 2013; 56: 50-54.

13. Felker GM, Allen LA, Pocock SJ, et al. Red cell distribution width as a novel prognostic marker in heart failure: data from the CHARM Program and the Duke Databank. J Am Coll Cardiol 2007; 50: 40-47.

14. Malandrino N, Wu WC, Taveira TH, et al. Association between red blood cell distribution width and macrovascular and microvascular complications in diabetes. Diabetologia 2012; 55: 226-235.

15. Narci H, Turk E, Karagulle E, Togan T, Karabulut K. The role of red cell distribution width in the diagnosis of acute appendicitis: a retrospective case-controlled study. World J Emerg Surg 2013; 8: 46-50.

16. Bozlu G, Taskinlar H, Unal S, et al. Diagnostic value of red blood cell distribution width in pediatric acute appendicitis. Pediatr Int 2016; 58: 202-205.

17. Yang HR, Wang YC, Chung PK, et al. Role of leukocyte count, neutrophil percentage, and Creactive protein in the diagnosis of acute appendicitis in the elderly. Am Surg 2005; 71: 344-347.

18. Hallan S, Asberg A, Edna TH. Additional value of biochemical tests in suspected acute appendicitis. Eur J Surg 1997; 163: 533-538.

19. Shimizu T, Ishizuka M, Kubota K. A lower neutrophil to lymphocyte ratio is closely associated with catarrhal appendicitis versus severe appendicitis. Surg Today 2016; 46: 84-89.

20. Markar SR, Karthikesalingam A, Falzon A, Kan Y. The diagnostic value of neutrophil: lymphocyte ratio in adults with suspected acute appendicitis. Acta Chir Belg 2010; 110: 543-547.

21. Yazici M, Ozkisacik S, Oztan MO, Gürsoy H. Neutrophil/lymphocyte ratio in the diagnosis of childhood appendicitis. Turk J Pediatr 2010; 52: 400-403.

22. Acikgoz N, Karincaoglu Y, Ermis N, et al. Increased mean platelet volume in Behçet's disease with thrombotic tendency. Tohoku J Exp Med 2010; 221: 119-123.

23. Goodman DA, Goodman CB, Monk JS. Use of the neutrophil:lymphocyte ratio in the diagnosis of appendicitis. Am Surg 1995; 61: 257-259.

24. Jahangiri M, Wyllie JH. Peripheral blood lymphopenia in gangrenous appendicitis. BMJ 1990; 301: 215.

25. Zahorec R. Ratio of neutrophil to lymphocyte counts rapid and simple parameter of systemic inflammation and stress in critically ill. Bratisl Lek Listy 2001; 102: 5-14.

26. Ugur M, Gul M, Bozbay M, et al. The relationship between platelet to lymphocyte ratio and the clinical outcomes in ST elevation myocardial infarction underwent primary coronary intervention. Blood Coagul Fibrinolysis 2014; 6: 212-216.

27. Lou Y, Wang M, Mao W. Clinical usefulness of measuring red blood cell distribution width in patients with Hepatitis B. PLoS One 2012; 7: e37644.

28. Chen B, Ye B, Zhang J, Ying L, Chen Y. RDW to Platelet Ratio: A novel noninvasive index for predicting hepatic fibrosis and cirrhosis in chronic hepatitis. B. PLoS One 2013; 8: e68780.
Eastern Journal of Medicine-Cover
  • ISSN: 1301-0883
  • Başlangıç: 1996
  • Yayıncı: ERBİL KARAMAN
Sayıdaki Diğer Makaleler

The effect of super-oxidized water on the tissues of uterus and ovary: An experimental rat study

ABBAS ARAS, ERBİL KARAMAN, Numan ÇİM, SERKAN YILDIRIM, REMZİ KIZILTAN, ÖZKAN YILMAZ

Rare angiosarcoma of inferior turbinate; A case report and literature review

Mohd Eksan SAİRİN, Noorizan YAHYA, Chew Yok KUAN, Mohamad Khir ABDULLAH, Salina HUSAİN1

Congestive cardiac failure as a presentation of neonatal Graves in twin

Somosri RAY, Rakesh MONDAL, Tapas SABUİ, Rupa BİSWAS

Evaluation of patients operatively treated with a diagnosis of lumbar disc hernia: An epidemiological investigation

ABDURRAHMAN AYCAN, İsmail GULSEN, MEHMET ARSLAN, Fetullah KUYUMCU, MEHMET EDİP AKYOL

Mean platelet volume, red cell distribution width, neutrophil to lymphocyte ratio and platelet to lymphocyte ratio in the diagnosis of acute appendicitis

OSMAN TOKTAŞ, MEHMET ASLAN

Two novel associations in a case with Walker Warburg syndrome; Enophthalmia, interhemispheric cyst and cerebral hematoma

Sultan KABA, Murat DOĞAN, Mehmet Deniz BULUT, Keziban BULAN, Nihat DEMİR, Lokman ÜSTYOL, Zeyneb Ümit BOZDOĞAN, Nesrin CEYLAN

A different approach in removal of proximal Wharton's duct stone: Case report

Mahfuz TURAN, Mehmet Fatih GARCA, Ahmet Faruk KIROGLU, Koray AVCI, Nazım BOZAN, Hakan CANKAYA, Huseyin OZKAN

Comparison of ultrasound guided brachial plexus blockage with general anesthesia and cost analysis

Abdullah KAHRAMAN, NUREDDİN YÜZKAT, Muhammed Bilal ÇEĞİN, Volkan BAYDİ

A different approach in removal of proximal Wharton's duct stone: Case report

MAHFUZ TURAN, Hüseyin ÖZKAN, Mehmet Fatih GARÇA, Hakan ÇANKAYA, Koray AVCI, Nazım BOZAN, Ahmet Faruk KIROĞLU