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Assessment of calprotectin in ascitic fluid as a marker for spontaneous bacterial peritonitis diagnosis in cirrhotic patients

The Egyptian Journal of Internal Medicine volume 30, pages 223–230 (2018)Cite this article

Abstract

Background

Spontaneous bacterial peritonitis (SBP) is a serious infection of ascitic fluid in cirrhotic patients. High mortality associated with the delay in diagnosis and treatment. There is a need for an accurate and a rapid method for SBP diagnosis.

Objectives

We aimed to evaluate ascitic fluid calprotectin as a diagnostic marker for SBP.

Patients and methods

Forty four cirrhotic patients were divided into two groups, non-SBP group: 22 patients with cirrhotic ascites without evidence of SBP and SBP group: 22 patients with cirrhotic ascites and SBP diagnosed by positive ascitic fluid bacterial culture and an increase in polymorphonuclear leukocytes (PMNLs) count in ascites (≥250 cells/mm3). Ascitic fluid calprotectin levels were measured using enzyme-linked immunosorbent assay.

Results

There was a significant increase of ascitic fluid calprotectin, total leukocytic count, PMNLs, lactate dehydrogenase, and total protein in SBP group when compared to non-SBP group. There were significant positive correlations between white blood cell, ascitic fluid total leukocytic count, PMNLs, total protein, and model for end-stage liver disease score values and ascitic fluid calprotectin among SBP group. Ascitic fluid calprotectin with cutoff value 620 ng/ml, showed a sensitivity of 90.91% and a specificity of 95.45%, in diagnosis of SBP with positive predictive value 95.2% and negative predictive value 91.3%.

Conclusion

Ascitic fluid calprotectin may be valuable in rapid diagnosis of SBP.

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Authors and Affiliations

  1. Department of Internal Medicine, Faculty of Human Medicine, Zagazig University, Endocrinology Unit, Egypt. Sharkyia Governorate, Zagazig City, 44519, Egypt

    Fayrouz O. Selim MD, Nahawand A. El-Deeb & Hesham A. Farrag

  2. Department of Clinical Pathology, Faculty of Medicine, Zagazig University, Zagazig, Egypt

    Azza M. Ahmed

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  1. Fayrouz O. Selim MD
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  2. Nahawand A. El-Deeb
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Correspondence to Fayrouz O. Selim MD.

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Selim, F.O., El-Deeb, N.A., Farrag, H.A. et al. Assessment of calprotectin in ascitic fluid as a marker for spontaneous bacterial peritonitis diagnosis in cirrhotic patients. Egypt J Intern Med 30, 223–230 (2018). https://doi.org/10.4103/ejim.ejim_17_18

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  • DOI: https://doi.org/10.4103/ejim.ejim_17_18

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