The CBC has long been used to aid in the diagnosis of acute appendicitis, although its utility is contested. 56 and 7 The sensitivity of an elevated white blood count (WBC) above 10,000/pL in acute appendicitis is 70 to 90 percent, but the specificity is very low. 7 More important, the positive and negative predictive values of an elevated WBC in acute appendicitis are 92 and 50 percent, respectively. 8 In general, the WBC has limited value in the diagnosis of acute appendicitis. Clearly, overreliance on an elevated WBC will lead the clinician astray and potentially delay necessary surgery. The diagnostic value of C-reactive protein and erythrocyte sedimentation rate have been studied in acute appendicitis with mixed results. 910 and11
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