CAN SERUM INTERLEUKIN-6 LEVELS PREDICT THE OUTCOME OF PATIENTS WITH RIGHT ILIAC FOSSA PAIN

In patients with right iliac fossa (RIF) pain it can be difficult to d istinguish between appendicitis and nonspecific abdominal pain (NSAP). In this study we sought to determine whether serum interleukin-6 (IL- 6) levels, an early marker of acute inflammation, taken at the time of admission could predict the outcome of patients admitted with RIF pai n. Data were collected in a prospective manner on 53 consecutive patie nts (23 male, 30 female), mean age 22.1 years (range 10-79 years). Nin eteen (36%) patients underwent surgery, of whom 16 had appendicitis (h istologically proven). The mean (SEM) IL-6 levels (pg/ml) in patients undergoing operation vs those receiving non-operative management were 270.8 (106.3) vs 265.0 (80.4) (P = NS). The mean white blood cell (WBC ) counts (x 10(9)/1) in these patients were 14.28 (0.81) vs 9.66 (0.67 ), respectively (P = 0.0002). When patients with a confirmed diagnosis of appendicitis were compared with patients with a diagnosis of NSAP, the IL-6 levels were 149.4 (69.1) vs 363.6 (113.2), respectively (P = NS). In the same groups of patients, the WBC counts were 14.21 (0.81) vs 9.51 (0.68) (P = 0.004). We conclude that IL-6 levels taken at the time of admission are not useful in predicting the outcome of RIF pai n.