Investigational Urine Test Aids Appendicitis Diagnosis

An experimental pediatric urine test could one day spot appendicitis faster and more accurately than current tests, claims a new study.

Researchers at Children's Hospital Boston (CHB, MA, USA) first examined urine samples from six patients with appendicitis and six without appendicitis. The researchers then identified 32 possible associated biomarkers; to these, they added 25 other markers found in gene studies. The researchers then looked for these 57 potential markers in 67 children with possible appendicitis; among these children, 25 actually did have appendicitis. Tests of performance of the markers were evaluated against the pathologic diagnosis and histologic grade of appendicitis. The researchers eventually identified seven biomarkers linked with appendicitis that exhibited favorable diagnostic performance, including calgranulin A (S100-A8), alpha-1-acid glycoprotein 1 (orosomucoid), and leucine-rich alpha-2-glycoprotein (LRG). LRG especially was enriched in diseased appendices, and its abundance correlated with severity of appendicitis. The study was published ahead of print in the June 23, 2009, online edition of the Annals of Emergency Medicine.

"We have found a protein in the urine that is diagnostic for appendicitis,” said study co-author Hanno Steen, Ph.D., director of the proteomics center at CHB. "This would mean that diagnosis of appendicitis is faster, more reliable and much more cost-efficient.”

Ultrasound and computed tomography (CT) scans are currently used to diagnose appendicitis, yet 3-30% of children have unnecessary appendectomies, while 30-45% of those diagnosed with appendicitis already have a ruptured appendix. In addition, patients can wait hours in the emergency room before they are able to have these tests; the new test could diagnose appendicitis in just 30 minutes and result in fewer unnecessary surgeries. However, the test still needs to be validated in adults.

Related Links:
Children's Hospital Boston