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Dear Sir

We would like to thank Georgios Christopoulos and Tony Kelly for their comments. As they quite rightly point out, IL-6 appears to be a promising marker for the diagnosis of ovarian torsion in women with an ovarian cyst, and we read with interest the results of your meta-analysis. Its value as a marker alone or in combination with other demographic, biochemical and ultrasound variables remains unclear, and further work would be welcomed to assess its use prospectively as a diagnostic test, however we stand by our comment that we do not currently have sufficient evidence from the literature to recommend its use.