Diagnosing appendicitis at different time points in children with right lower quadrant pain: Comparison between pediatric appendicitis score and the alvarado score: Reply

摘要

We appreciate the interest and important comments on our article regarding comparison of the Pediatric Appendicitis Score (PAS) and Alvarado score in diagnosing appendicitis in children [1]. In both scoring systems, leu-kocytosis is one of the variables (PAS score gives 1 point to white blood cell (WBC) >10 x 109/L; Alvarado score gives 2 points to WBC >10.4 x 109/L). The upper limit of WBC count does show different normal ranges in different age groups [2]. The upper limit of WBC at age six is 14.5 (xlO9/L) and at age 12 it is 13.5 (x109/L), and after 12 years WBC returns to adult levels [2]. However, neither or the scoring systems mentions the different cutoff values of WBC counts in predicting acute appendicitis for children younger than 12 years of age.