Dynamic Thiol/Disulphide Homeostasis a Promising New Marker in the Diagnosis of Acute Appendicitis in Children: A Case Control Study of Acute Appendicitis and Abdominal Pain

Objectives: One of the most common emergency surgery in pediatric surgery is due to acute appendicitis (AA). The diagnosis of AA is usually made using with the clinical score using clinical signs, symptoms, and laboratory tests. But symptoms and signs are not always typical, and this situation put clinician in a compelling situation. The range of misdiagnosis of AA is between 28-57 % between 2-12 years old children. Thiol/Disulphide homeostasis is an important indicator of oxidative stress and inflammation. This study is aimed to evaluate and compare the feasibility of thiol/disulphide levels in pediatric patients with AA and abdominal pain (AP). Methods: In this case-control study three different group established with 25 healthy participants (NCG), 25 patients with abdominal pain (PCG), and 25 with AA (AAG). Demographics, white blood cell count, neutrophil-lymphocyte counts, hemoglobin, platelet, mean platelet volume, C-reactive protein, total thiol (TT), native thiol, (NT) and disulphide (DS) levels measure through blood samples. Results: According to our result, the level of NT were significantly lower in AAG when compared with NCG and PCG (p<0.001). DS levels were significantly higher in AAG than in NCG (p<0.001). CRP levels were significantly higher in both PCG and AAG than those of NCG p<0.001). Conclusion: Thiol/disulphide homeostasis is a valuable method to examine acute appendicitis in the pediatric patients. Fluctuations of thiol/disulphide homeostasis could be used as a marker in daily clinical practice for diagnosis of appendicitis.