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Appendicitis urine test hope

23rd June 2009

Appendicitis, a potentially life-threatening condition without emergency surgery, may soon be detectable with a simple test.

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Researchers at the Children's Hospital of Boston say a urine test may be all that is needed to detect appendicitis.

A specific protein appears in the urine of some patients with the condition, and may form the basis of the new diagnostic procedure.

Published online in the Annals of Emergency Medicine, the research found that mass spectrometry analysis of 12 urine samples from children came up with dozens of compounds which might act as indicators of appendicitis.

Altogether, there were 57 compounds associated with immune response and inflammation which could lead to a new test.

A new test kit would slash the risk of serious complications ensuing from a failure to detect appendicitis, or the likelihood of unnecessary surgery in the case of a false positive diagnosis.

Nearly 30% of children who have emergency surgery to remove their appendix do so unnecessarily.

At the other end of the error scale, as much as 45% already have a ruptured appendix, which leads to peritonitis and death if untreated, when they reach the operating table.

After the 57 potential markers were identified, further tests were carried out on 67 children with suspected appendicitis at the hospital, resulting in seven possible candidates to form the basis of a test.

The most like protein was leucine-rich alpha-2-glycoprotein (LRG), which is seen in elevated levels in diseased appendices, even when scans appear normal.

LRG levels were also found to be in direct proportion to the seriousness of the appendicitis.

The research team said the results could pave the way for a urine dipstick test for appendicitis based on LRG.

Further research was now needed on adult patients, as their biomarkers might not be the same, the team said.

Researcher Richard Bachur said that while recent diagnostic advances had focused on advanced radiologic procedures, such resources were not universally available, delaying diagnosis.

CT scans of children have also been linked to increase cancer risk in later life.

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