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Role of C Reactive Protein, White Blood Cell Counts, Polymorph Percentage and Histopathological Findings in Diagnosing Appendicitis

Arpana Dharwadkar Associate Professor Dept. of Pathology, Dr. D.Y. Patil Medical College, Hospital & Research Centre, Pimpri, Pune, Maharashtra 411018, India. , Shruti Vimala , Arpana Dharwadkarb , Vidya Viswanathanc , Manpreet Mathrud , S.L. Jadhave

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Indian Journal of Pathology: Research and Practice 7(2):p 142-149, February 2018. | DOI: http://dx.doi.org/10.21088/ijprp.2278.148X.7218.3

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Abstract

Background: Acute appendicitis is the most common surgical emergency associated with an acute phase reaction. The diagnosis of the same is based on detailed clinical history and examination, laboratory and imaging interventions. The aim of the study is to study the role of C- reactive protein, white blood cell counts and polymorph percentage with histopathological examination for accurate diagnosis of appendicitis. Materials and Methods: It’s a retrospective study conducted in, patients presenting with features suggestive of appendicitis and were taken from1st January 2017 to 31st July 2017. The various clinical manifestations were considered and total of 100 cases were included in the study. The correlation of clinical presentation, with laboratory markers like CRP, total WBC counts and Neutrophil percentage with histopathological presentation was done. Results: The CRP levels significantly differed from gangrenous appendicitis (Group C) and catarrhalis and phlegmonous appendicitis (Group B). As compared to Total leucocyte counts and polymorphs percentage the CRP assay had sensitivity of 100% and specificity of 90% in comparison to WBC counts and Polymorph percentages which had a sensitivity of 55% and 75%. The total diagnostic accuracy of CRP assay was 97.7% Conclusion: The diagnostic accuracy of C reactive protein is not significantly higher than WBC and Neutrophil percentages. Though the values of CRP are directly proportional to the severity of inflammation. The combination of CRP, WBC and the polymorph counts together have a greater diagnostic accuracy in cases of appendicitis.

Keywords: Acute Appendicitis; CRP; WBC; Neutrophil Percentage; Histopathology. 

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DOI: http://dx.doi.org/10.21088/ijprp.2278.148X.7218.3

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