{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,21]],"date-time":"2026-02-21T10:58:48Z","timestamp":1771671528031,"version":"3.50.1"},"reference-count":31,"publisher":"Georg Thieme Verlag KG","issue":"03","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Eur J Pediatr Surg"],"published-print":{"date-parts":[[2022,6]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>\n          Introduction\u2003The aim of this study was to make the differential diagnosis between acute appendicitis and multisystem inflammatory syndrome in children (MIS-C) for patients presenting with the complaint of acute abdominal pain (AAP) and to identify the determining factors for the diagnosis of MIS-C.<\/jats:p><jats:p>\n          Materials and Methods\u2003Eighty-one children presenting with AAP\/suspected AAP were evaluated. Of these, 24 (29.6%) were included in the MIS-C group (MIS-C\/g) and 57 were included in the suspected appendicitis group (S-A\/g), which consisted of two subgroups: appendicitis group (A\/g) and control observation group (CO\/g).<\/jats:p><jats:p>\n          Results\u2003Comparing MIS-C\/g, A\/g, and CO\/g, duration of abdominal pain (2.4, 1.5, 1.8 days), high-grade fever (38.8, 36.7, 37\u00b0C), severe vomiting, and severe diarrhea were higher in MIS-C\/g. Lymphocytes count (LC) was lower, while values of C-reactive protein (CRP), ferritin, and coagulopathy were higher in MIS-C\/g (p\u2009&lt;\u20090.05). The optimal cutoffs for the duration of abdominal pain was 2.5 days; the duration of fever, 1.5 days; peak value of fever, 39\u00b0C; neutrophil count, 13,225\u2009\u00d7\u20091,000 cell\/\u00b5MoL; LC, 600\u2009\u00d7\u20091,000 cell\/\u00b5MoL; ferritin, 233 \u00b5g\/L; and D-dimer, 16.4\u2009mg\/L (p\u2009&lt;\u20090.05). The optimal cutoff for CRP was 130\u2009mg\/L (sensitivity 88.9, specificity 100%, positive predictive value 100%, NPV, negative predictive value 92.5%, p\u2009&lt;\u20090.001). All patients in MIS-C\/g tested positive by serology by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2).<\/jats:p><jats:p>\n          Conclusion\u2003The duration of abdominal pain, presence of high-grade and prolonged fever, and evaluation of hemogram in terms of high neutrophil count and low LC exhibit high sensitivity and negative predictive value for MIS-C presenting with AAP. In case of doubt, inflammatory markers such as CRP, ferritin, D-dimer, and serology for SARS-CoV-2 should be studied to confirm the diagnosis.<\/jats:p>","DOI":"10.1055\/s-0041-1732320","type":"journal-article","created":{"date-parts":[[2021,7,23]],"date-time":"2021-07-23T22:44:31Z","timestamp":1627080271000},"page":"240-250","source":"Crossref","is-referenced-by-count":6,"title":["Determination of Factors to Distinguish MIS-C from Acute Appendicitis in Children with Acute Abdominal Pain"],"prefix":"10.1055","volume":"32","author":[{"given":"M\u00fcjdem Nur","family":"Az\u0131l\u0131","sequence":"additional","affiliation":[{"name":"Department of Pediatric Surgery, Ankara City Children's Hospital, Ankara Yildirim Beyazit University, Ankara, Turkey"},{"name":"Department of Pediatric Surgery, Ankara City Hospital, Cankaya, Ankara, Turkey"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7168-2123","authenticated-orcid":false,"given":"Do\u011fu\u015f","family":"G\u00fcney","sequence":"additional","affiliation":[{"name":"Department of Pediatric Surgery, Ankara City Children's Hospital, Ankara Yildirim Beyazit University, Ankara, Turkey"},{"name":"Department of Pediatric Surgery, Ankara City Hospital, Cankaya, Ankara, Turkey"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5408-2772","authenticated-orcid":false,"given":"Can Ihsan","family":"Oztorun","sequence":"additional","affiliation":[{"name":"Department of Pediatric Surgery, Ankara City Children's Hospital, Ankara Yildirim Beyazit University, Ankara, Turkey"},{"name":"Department of Pediatric Surgery, Ankara City Hospital, Cankaya, Ankara, Turkey"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ahmet","family":"Ert\u00fcrk","sequence":"additional","affiliation":[{"name":"Department of Pediatric Surgery, Ankara City Hospital, Cankaya, Ankara, Turkey"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Elif Emel","family":"Erten","sequence":"additional","affiliation":[{"name":"Department of Pediatric Surgery, Ankara City Hospital, Cankaya, Ankara, Turkey"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sabri","family":"Demir","sequence":"additional","affiliation":[{"name":"Department of Pediatric Surgery, Ankara City Hospital, Cankaya, Ankara, Turkey"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ay\u015fe","family":"Ertoy","sequence":"additional","affiliation":[{"name":"Department of Pediatric Surgery, Ankara City Hospital, Cankaya, Ankara, Turkey"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Serhat","family":"Emeksiz","sequence":"additional","affiliation":[{"name":"Department of Pediatric Intensive Care, Ankara Yildirim Beyazit University, Ankara, Turkey"},{"name":"Department of Pediatric Intensive Care, Ankara City Hospital, Cankaya, Ankara, Turkey"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Asl\u0131nur Ozkaya","family":"Parlakay","sequence":"additional","affiliation":[{"name":"Department of Pediatric Infection, Ankara Yildirim Beyazit University, Ankara, Turkey"},{"name":"Department of Pediatric Infection, Ankara City Hospital, Cankaya, Ankara, Turkey"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Banu Acar","family":"Celikel","sequence":"additional","affiliation":[{"name":"Department of Pediatric Rheumatology, Ankara City Hospital, Cankaya, Ankara, Turkey"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Emrah","family":"Senel","sequence":"additional","affiliation":[{"name":"Department of Pediatric Surgery, Ankara City Children's Hospital, Ankara Yildirim Beyazit University, Ankara, Turkey"},{"name":"Department of Pediatric Surgery, Ankara City Hospital, Cankaya, Ankara, Turkey"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"194","published-online":{"date-parts":[[2021,7,23]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","DOI":"10.2500\/aap.2020.42.200104","article-title":"COVID-19 in children: pathogenesis and current status","author":"L Frenkel","year":"2020","journal-title":"Allergy Asthma Proc"},{"issue":"03","key":"ref2","doi-asserted-by":"crossref","first-page":"299","DOI":"10.1007\/s12098-020-03508-4","article-title":"COVID abdomen: SARS-CoV-2 infection presenting as \u2018Acute Abdomen\u2019in a child","volume":"88","author":"M 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Choi","year":"2020","journal-title":"Pediatrics"}],"container-title":["European Journal of Pediatric 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