Research Information System
Scandinavian Journal of Rheumatology, 2025 (SCI-Expanded)
Objective: This study aimed to investigate the diagnostic value of inflammatory markers and the delta neutrophil index (DNI) in differentiating familial Mediterranean fever (FMF) attacks from acute appendicitis (AA). Method: This retrospective analysis evaluated patients aged 0–18 years presenting with FMF attacks or suspected AA to Ankara Bilkent City Hospital Children’s Hospital between 2019 and 2024. The FMF group comprised patients meeting ICD Eurofever/PRINTO classification criteria during an attack, while the AA group comprised pathologically confirmed AA cases. White blood cell count (WBC), absolute neutrophil count (ANC), absolute lymphocyte count (ALC), platelet count (PLT), C-reactive protein (CRP), DNI, and neutrophil-to-lymphocyte ratio (NLR) were recorded retrospectively. Results: The study included 600 patients (200 FMF, 400 AA). WBC, ANC, NLR, and DNI values were significantly higher in the AA group (p < 0.001), whereas ALC and CRP were markedly elevated in the FMF group (p < 0.001). In receiver operating characteristics curve analysis, WBC, ANC, and NLR demonstrated high diagnostic performance, while DNI had limited value in distinguishing between the conditions. However, multivariate logistic regression showed that increases in DNI and ANC, and decreases in CRP and PLT levels, were statistically significant predictors of AA (p < 0.001). Conclusion: In differentiating FMF attacks from AA in children, physical examination and imaging can be supported by blood count-based parameters. Combined evaluation of multiple laboratory markers may accelerate decision making in paediatric patients and contribute to effective management. However, their utility in routine practice should be interpreted with caution and supported by further research.