Serum ischemia modified albumin level in the differential diagnosis of acute appendicitis and non-specific abdominal pain of children

Objectives: To investigate the role of the ischemia modified albumin (IMA) and the IMA/albumin ratio (IMA/AlbR) in the differential diagnosis of acute appendicitis (AA) in children applying to the emergency service due to the complaint of abdominal pain Design: Prospective study Setting: The study was conducted in the pediatric emergency department of a tertiary care hospital. Subjects: Children with abdominal pain Interventions: The patients were separated into two groups; AA and non-specific abdominal pain (NSAP) groups. White blood cell (WBC), neutrophil-lymphocyte ratio (NLR), C-reactive protein (CRP), IMA and IMA/AlbR levels were compared between the two groups and the receiver operating characteristic (ROC) analysis was performed. Main outcome measures: AA patients had a differential diagnosis based on NSAP Results: It was found that WBC, NLR, CRP, IMA, and IMA/ AlbR results were significantly higher in AA group than NSAP group. According to the ROC analysis, the cut-off value was 0.777 AbsU for IMA and 16.71% for IMA/AlbR, in distinguishing the patients in AA group from those in NSAP group. When IMA or IMA/AlbR was included into any of WBC, NLR and CRP tests, the sensitivity and specificity values were found to be 87.5% and 88.9% for WBC-IMA, 80.9% and 84.2% for WBC-IMA/AlbR, 100% and 84.2% for NLR-IMA, 80.9% and 84.2% for NLR-IMA/ AlbR, 71.4% and 96% for CRP-IMA, and 27.7% and 95.8% for the CRP-IMA/AlbR. Conclusion: When IMA and IMA/AlbR parameters were added to the WBC, NLR and CRP tests in differential diagnosis of AA patients from NSAP patients, sensitivity and specificity in particular increased significantly.