Investing the relation between different types of acute appendicitis with the number of white blood cell and C-reactive protein level

Subject Areas :

Forough Khaleghi nezhad ¹ , Seyed Mojtaba Taheri ² , Ladan Shahba ³

1 -
2 -
3 -

Received: 2025-07-16 Accepted : 2025-10-12 Published : 2025-09-13

Keywords: acute appendicitis, White Blood Cell, C-reactive Protein,

Abstract :

Acute appendicitis is one of the surgical emergencies that has many differential diagnoses. The accuracy of clinical diagnosis in acute appendicitis is between 76% and 92%, and the error rate in acute appendicitis diagnosis is 9.3% in men and 23.2% in women. Therefore, it is important to use paraclinical help to diagnose and cure this disease, and prevent its complications. Considering the importance of diagnosis, we decided to determine the relationship between acute appendicitis and WBC count and CRP level in patients admitted to Payambar Azam Hospital in Kerman in 2022. All patients without age limitation visited Payambar Azam Hospital in Kerman in 2022 with abdominal pain suspected to be appendicitis were included in the study. All patient information, including age, gender, neutrophils, white blood cell count, C-reactive protein level, were extracted from the files and recorded in the data collection form. After data collection, SPSS version 20 software was used for analysis. In this study, 169 patients were examined, of which 82 (48.5%) were women and 87 (51.5%) were men. The average age of the patients was 24.28 ± 14.62. According to the type of appendicitis, 86 people (50.9%) were acute, 51 people (30.2%) had purulent appendicitis, and 32 people (18.9%) had gangrene. The frequency of positive C-reactive protein, White Blood Cells above 10000, and neutrophils was statistically significant according to the type of appendicitis. Due to the fact that there is a possibility that many diseases that cause symptoms like acute appendicitis will mistakenly lead to appendectomy, the results of our study showed that by measuring CRP and counting White Blood Cells along with clinical examination, appendectomy can be performed.

 

Keywords: Acute appendicitis, C-reactive Protein, White Blood Cell.

 

References:

[1] E. S., Clinical and laboratory findings in acute appendicitis in the elderly., vol. 9, The Journal of the American Board of Family Practice., 1996, pp. 75-8.
[2] E. H., Appendix and appendectomy., vol. 2, Maingot's abdominal operations., 1997, pp. 1191-227..
[3] G. M. C. S. Snyder MJ, Acute appendicitis: efficient diagnosis and management., vol. 98, American family physician., 2018, pp. 25-33.
[4] A.-G. A. H.-M. M. N.-T. F. P.-E. M. d. S. I. Díaz-Barrientos C, The RIPASA score for the diagnosis of acute appendicitis: A comparison with the modified Alvarado score., vol. 83, Revista de Gastroenterología de Méxio (English Edition), 2018, pp. 112-6.
[5] W. W. S. G. H. R. Livingston EH, Disconnect between incidence of nonperforated and perforated appendicitis: implications for pathophysiology and management., vol. 245, Annals of surgery., 2007.
[6] F. DR., Acute appendicitis—appendectomy or the “antibiotics first” strategy., vol. 372, New England Journal of Medicine., 2015, pp. 1937-43..
[7] M. N. S. F. R. M. ,. M. P. Shiva Pakzad1, Diagnostic value of C- reactive protein and white blood count in patients with suspicious appendicitis, vol. 41, Medical Journal of Tabriz University of Medical Sciences and Health Services, 2019, pp. 17-24.
[8] S. T. M. J. S. S. O. P. Y. H. e. a. Saluja S, Early versus late surgical management of complicated appendicitis in children: a statewide database analysis with one-year follow-up., vol. 53, Journal of pediatric surgery., 2018, pp. 1339-44.
[9] G. L. C. A. Eriksson S, The diagnostic value of repetitive preoperative analyses of C-reactive protein and total leucocyte count in patients with suspected acute appendicitis., vol. 29, Scandinavian journal of gastroenterology., 1994, pp. 1145-9.
[10] C. R. D. I. K. D. K. A. Y. U. B. E. B. Ori Snapiri, Delayed diagnosis of paediatric appendicitis during the COVID-19 pandemic, vol. 109, Acta Paediatrica, 2020, pp. 1672-67.
[11] G. J., Do normal leucocyte count and C‐reactive protein value exclude acute appendicitis in children?, Acta Paediatrica., 2001.
[12] M. A. L. M. K. J. K. S. Paajanen H, Are serum inflammatory markers age dependent in acute appendicitis?, Journal of the American College of Surgeons., 1997.
[13] M. M. T. E.Rezaei, Accuracy of serum CRP measurement and WBC count in diagnosis of patients suspected to acute Appendicitis, vol. 90, J Gorgan Univ Med Sci, 2004, pp. 649-51..
[14] M. Y. B. S. S. H. R. F. Javadi M, Evaluation of the Sensitivity and Specificity C- reactive protein, and leukocyte count in the diagnosis of acute appendicitis and its types., Pajouhan Sci J, 2013.
[15] M. M. Khorrami, EVALUATION OF SERUM CRP, PROCALCITONIN AND WBC IN THE DIAGNOSIS OF ACUTE APPENDICITIS, Iranian Journal of Surgery, 2011.
[16] G. G. U. S. Gurleik E, Accuracy of serum CRP measurement in diagnosis of acute appendicitis compared with surgeon clinical Impression., Dis Colon Rectum , 1995.
[17] B. D. B. F. A. D. B. T. Jaffe B, The appendix., Schwartz's Principles of Surgery., 2000.
[18] D. N. A. S. O. H. Mohammed AA, The diagnostic value of C-reactive protein, white blood cell count and neutrophil percentage in childhood appendicitis., Saudi Med J, 2004.
[19] M.-P. J. S. I. G.-C. L. N. A. Rodríguez-Sanjuán JC, C-reactive protein and leukocyte count in the diagnosis of acute appendicitis in children., Dis Colon Rectum. , 1999.
[20] S. H. K. M. D. H. a.-. B. A. Asfar S, Would measurement of C-reactive protein reduce the rate of negative exploration for acute appendicitis?, J R Coll Surg Edinb, 2000.
[21] W. Y. C. P. C. W. J. L. C. R. Yang HR, Laboratory tests in patients with acute appendicitis., ANZ J Surg., 2006.
[22] S. HS., The accuracy of C-reactive protein in the diagnosis of acute appendicitis compared with that of clinical diagnosis., Med Arh, 2000.