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Ascitic calprotectin as a diagnostic marker for spontaneous bacterial peritonitis in hepatitis C virus cirrhotic Egyptian patients

The Egyptian Journal of Internal Medicine volume 30, pages 1–7 (2018)Cite this article

Abstract

Background

The gold standard for the diagnosis of spontaneous bacterial peritonitis (SBP) is a polymorphonuclear leukocyte (PMNL) count of 250/mm3or more. Accurate and early diagnosis of SBP is important to decrease the mortality and complications in patients with cirrhosis.

Aims

The aim of this study was to evaluate the accuracy of ascitic fluid calprotectin as a diagnostic marker for the detection of SBP.

Patients and methods

Seventy Egyptian patients with liver cirrhosis and ascites were enrolled; these patients were divided into two groups: 50 patients with SBP and 20 patients with no SBP on the basis of an elevated ascitic PMNL count of 250 cells/mm3 or more. Ascitic samples were examined for PMNL count, culture, chemistry, and calprotectin concentrations in all patients.

Results

Calprotectin levels in ascitic fluid were correlated significantly with PMNLs and significantly higher in patients with SBP than non-SBP (P <0.001), with the best cutoff value for the detection of SBP of 783 ng/ml with a sensitivity, a specificity, a positive predictive value and negative predictive value, and an accuracy of 90, 100, 100, 80, and 92.9%, respectively.

Conclusion

Elevated ascitic calprotectin levels in cirrhotic patients are a diagnostic and reliable marker for the detection of SBP and considered a surrogate marker for PMNL.

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Authors and Affiliations

  1. Department of Internal Medicine, Cairo University Medical School, Kasr Alaini Street, 11562, Cairo, Egypt

    Ahmed A. Heikl MD, Mahmoud M. El-Nokeety & Eman Roshdy

  2. Department of Clinical and Chemical Pathology, Cairo University Medical School, Cairo, Egypt

    Abeer Mohey

Authors
  1. Ahmed A. Heikl MD
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  2. Mahmoud M. El-Nokeety
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  3. Eman Roshdy
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  4. Abeer Mohey
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Corresponding author

Correspondence to Ahmed A. Heikl MD.

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Heikl, A.A., El-Nokeety, M.M., Roshdy, E. et al. Ascitic calprotectin as a diagnostic marker for spontaneous bacterial peritonitis in hepatitis C virus cirrhotic Egyptian patients. Egypt J Intern Med 30, 1–7 (2018). https://doi.org/10.4103/ejim.ejim_41_17

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  • DOI: https://doi.org/10.4103/ejim.ejim_41_17

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