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2025, Número 2-3

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Alerg Asma Inmunol Pediatr 2025; 34 (2-3)


Eosinófilos, índice neutrófilos-linfocitos y otros biomarcadores en la apendicitis aguda complicada. Estudio de casos y controles

Bucio-Cornejo DP, Medina VI, Espinosa-Padilla SE, Contreras-Verduzco FA, Arce-Estrada GE

Idioma: Portugués
Referencias bibliográficas: 51
Paginas: 49-59
Archivo PDF: 558.26 Kb.


RESUMEN

Introducción: el abordaje diagnóstico de la apendicitis aguda incluye el historial del paciente, la exploración física, las pruebas de imagen y los análisis de laboratorio, como el hemograma. Objetivos: investigar la asociación entre los casos complicados (perforados) de apendicitis aguda en niños y los biomarcadores del hemograma. Material y métodos: se realizó un estudio de casos y controles en un hospital de segundo nivel de la Ciudad de México, en el que se comparó a pacientes con apendicitis aguda no complicada (grupo de control) y con apendicitis aguda complicada y distintos grados de gravedad (grupo de casos). El estudio utilizó los registros clínicos de pacientes menores de 18 años a los que se les diagnosticó apendicitis aguda y se les realizó un hemograma antes de la cirugía. El estudio abarcó el periodo comprendido entre 2019 y 2023. Resultados: se incluyeron 278 historias clínicas, de las cuales 53.6% correspondía a varones. La edad media fue de 9.9 ± 4 años; 73.7% de los casos presentaba apendicitis aguda complicada. Los recuentos de leucocitos y neutrófilos, así como las relaciones neutrófilos/linfocitos y neutrófilos/plaquetas, fueron más elevados en el grupo de apendicitis complicada. La linfopenia fue más frecuente en los niños más pequeños. En el análisis multivariante, ≥ 55 eosinófilos/mm3 (OR = 2.2, IC de 95%: 1.2-4, p = 0.005) y el valor de ≥ 3.18 en la relación neutrófilos/linfocitos (OR = 4.4, IC de 95%: 2.2-8.5; p < 0.001) se asociaron con la apendicitis complicada. Conclusión: el hemograma completo es una herramienta útil para identificar casos de apendicitis aguda complicada en niños. Este estudio propone un punto de corte para los eosinófilos y otros biomarcadores sanguíneos con el fin de identificar casos complicados de apendicitis aguda.


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