{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T01:22:18Z","timestamp":1760059338494,"version":"build-2065373602"},"reference-count":27,"publisher":"MDPI AG","issue":"6","license":[{"start":{"date-parts":[[2025,6,11]],"date-time":"2025-06-11T00:00:00Z","timestamp":1749600000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Medicina"],"abstract":"<jats:p>Background: Acute appendicitis (AA) is a common surgical emergency worldwide. Over the past few decades, diagnostic imaging has become a cornerstone in the identification of acute appendicitis, significantly contributing to the reduction in unnecessary laparotomies and associated healthcare costs. This study aimed to investigate the influence of serum and spot urine 5-hydroxyindoleacetic acid (5-HIAA) levels, as well as other established clinical and biochemical parameters on the diagnosis of acute appendicitis. Methods: This prospective study was conducted between January and November 2023, evaluating 97 patients diagnosed with acute appendicitis. Serum and spot urine 5-HIAA levels, level of white blood cell (WBC), neutrophils, lymphocytes, platelets, C-reactive protein (CRP), and Alvarado score were analyzed. Patients were further allocated to subgroups based on their Alvarado scores, the onset time of the symptoms, and pathological findings to statistically assess the relationship between the parameters. Results: The mean age of the patients was 34.6 \u00b1 14.8 years. Of the patients, 57 (58.8%) were male, and 40 (41.2%) were female. Spot urine 5-HIAA levels exhibited statistically significant variation among different symptom onset time groups, with elevated levels observed in patients presenting within the first 12 h of symptom onset (p &lt; 0.001). Neutrophil counts were significantly different among Alvarado score groups (p &lt; 0.001), whereas CRP levels significantly increased with the onset time of the symptoms (p &lt; 0.001). Conclusions: Increased spot urine 5-HIAA is supportive of the diagnosis of AA in patients presenting within the first 12 h of symptom onset. Hematological parameters, especially CRP, may provide more reliable information regarding disease severity and progression.<\/jats:p>","DOI":"10.3390\/medicina61061070","type":"journal-article","created":{"date-parts":[[2025,6,11]],"date-time":"2025-06-11T06:11:49Z","timestamp":1749622309000},"page":"1070","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Urinary 5-HIAA as a Potential Diagnostic Marker in Acute Appendicitis: A Preliminary Report of Its Promising Role in Early Detection"],"prefix":"10.3390","volume":"61","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3097-1441","authenticated-orcid":false,"given":"Murat","family":"Demir","sequence":"first","affiliation":[{"name":"Department of General Surgery, Basaksehir Cam and Sakura City Hospital, University of Health Sciences, Istanbul 34480, Turkey"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4453-6339","authenticated-orcid":false,"given":"Alper","family":"Gumus","sequence":"additional","affiliation":[{"name":"Department of Biochemistry, Basaksehir Cam and Sakura City Hospital, University of Health Sciences, Istanbul 34480, Turkey"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8860-0630","authenticated-orcid":false,"given":"Huseyin","family":"Kilavuz","sequence":"additional","affiliation":[{"name":"Department of General Surgery, Basaksehir Cam and Sakura City Hospital, University of Health Sciences, Istanbul 34480, Turkey"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Feyyaz","family":"Gungor","sequence":"additional","affiliation":[{"name":"Department of General Surgery, Basaksehir Cam and Sakura City Hospital, University of Health Sciences, Istanbul 34480, Turkey"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sibel","family":"Yaman","sequence":"additional","affiliation":[{"name":"Department of General Surgery, Basaksehir Cam and Sakura City Hospital, University of Health Sciences, Istanbul 34480, Turkey"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Baki","family":"Ekci","sequence":"additional","affiliation":[{"name":"Department of General Surgery, Basaksehir Cam and Sakura City Hospital, University of Health Sciences, Istanbul 34480, Turkey"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Idris","family":"Kurtulus","sequence":"additional","affiliation":[{"name":"Department of General Surgery, Basaksehir Cam and Sakura City Hospital, University of Health Sciences, Istanbul 34480, Turkey"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2025,6,11]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"2299","DOI":"10.1001\/jama.2021.20502","article-title":"Diagnosis and Management of Acute Appendicitis in Adults: A Review","volume":"326","author":"Moris","year":"2021","journal-title":"JAMA"},{"key":"ref_2","first-page":"1736","article-title":"Acute appendicitis: Modern understanding of pathogenesis, diagnosis, and management","volume":"390","author":"Bhangu","year":"2017","journal-title":"Lancet"},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"506","DOI":"10.1016\/j.rx.2020.10.007","article-title":"The usefulness and positive predictive value of ultrasonography and computed tomography in the diagnosis of acute appendicitis in adults: A retrospective study","volume":"64","author":"Depetris","year":"2022","journal-title":"Radiologia"},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"138","DOI":"10.1016\/j.amsu.2020.09.029","article-title":"RIPASA and air scoring systems are superior to alvarado scoring in acute appendicitis: Diagnostic accuracy study","volume":"59","author":"Chisthi","year":"2020","journal-title":"Ann. 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