A research suggested that urine testing for leucine-rich alpha-2-glycoprotein and other biomarkers may help in the diagnosis of acute appendicitis.

The use of high-resolution CT and ultrasonography has led to improvements in the diagnosis of acute appendicitis, with respect to both the rates of complications and unnecessary appendectomies, Dr. Alex Kentsis, of Children’s Hospital Boston, and co-researchers note. However, significant diagnostic challenges remain, largely because of the nonspecific nature of signs and symptoms of many conditions that can mimic acute appendicitis.

According to authors, there remains a need for tests that can accurately detect acute appendicitis.

In the current study, the researchers profiled the proteins found in children with acute appendicitis versus those seen in their peers with other abdominal pain conditions, using high-accuracy mass spectrometry. In 67 children, 57 candidate markers were evaluated, including 37% with appendicitis.

Diagnostic performance was best in Calgranulin A, alpha-1-acid glycoprotein 1, and leucine-rich alpha-2-glycoprotein, with area under the ROC curve values of 0.84, 0.84, and 0.97, respectively.

The authors reported that Leucine-rich alpha-2-glycoprotein was increased in diseased appendices and its expression was directly related to disease severity.

This study will not change clinical practice but provides promising evidence of potential biomarkers useful in the diagnosis of appendicitis, the report concludes. Further testing of the utility of these biomarkers is needed.