levels of Lactate Dehydrogenase in Serum of patients with complicated acute Appendicitis

Abstract

Acute abdomen is a sudden and non-traumatic disorder that presents in abdomen. One of the most prevalent causes of acute abdomen is acute appendicitis. Acute appendicitis has variant presentations which sometimes leads to delay in diagnosis and misdiagnosis, or damage other organs and death. In order to diagnose the right patient, some modalities like imaging and laboratory tests are used. One of the most important data is white blood cell count (WBC) and its neutrophil percentage that has direct relation with severity of disease, but recent studies present that WBC has low sensitivity and there should be other parameters to help improving diagnosis. Results of recent studies showed that some biomarkers like lactate dehydrogenase (LDH), erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP) are useful and they have acceptable diagnostic value in differentiating complicated and uncomplicated appendicitis, despite these there are some studies that their results are vice versa, some present that these serum markers are likely equal in complicated and uncomplicated appendicitis. We aimed to conduct a study in order to ascertain the role of LDH, ESR and CRP in diagnosing acute complicated appendicitis.Methods and Materials: This study is across-sectional study. One hundred patients with acute appendicitis admitted in Sina hospital from March, 2019 to September, 2019 were evaluated in this study. Before surgery blood samples were taken to lab to check serum levels of LDH, ESR, CRP and also βhcg for female patients. Data including signs and symptoms like pain, nausea and vomiting, fever, anorexia and duration of illness were extracted from patient's dossiers. After surgery tissue samples were sent to pathology ward and reports were recorded. Based on pathology reports patients were divided in two groups, (complicated and uncomplicated). All data were analyzed in SPSS software.Results: Eighty-three patient were evaluated in this study. Forty nine(51%) were men and 34(49%) were women with average age of 30.86±10.76.based on pathology reports 39.8% were complicated appendicitis and 60.2% were uncomplicated. Duration of hospitalization was nearly 3 days in both groups and there wasn’t significant difference in both groups. Body temperature of patients with complicated appendicitis was significantly higher than the ones with uncomplicated appendicitis. Serum LDH in complicated group was higher than second group but not significantly (p=0.073). Other lab data as WBC, ESR, neutrophil count were similar in both groups except CRP which was markedly higher in complicated groups. Average of serum LDH in women was 338/86±123/47 and in men group was 337/18±159/58 which wasn’t significantly different. A direct relationship between LDH and WBC was seen.(p=0/017)