Ascitic calprotectin as a useful marker in the diagnosis of spontaneous bacterial peritonitis in adults

Rahman, Eman M Abdel; Attia, Fatma A; Alsebaey, Ayman; Elkady, Mohammad A.; Sayed, Maha Mohammed; Awad, Alaa; El-Seidi, Eman Ahmed

doi:10.1186/s43066-020-0022-7

Cited by 7 publications

(6 citation statements)

References 20 publications

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“…As regard bilirubin level of studied patients, we noted that median total and direct bilirubin were significantly higher in group І (3.2 mg/dl and 1.6 mg/dl, respectively) compared to group II (1.8 mg/dl and 0.65 mg/dl, respectively). Also, these results were similar to data recorded by Abdel-Rahman et al (17) who found that patients with SBP had statistically significant higher median total bilirubin compared to control group (4.2 vs. 2.3 mg/dL) respectively.…”

Section: Discussionsupporting

confidence: 91%

Ascitic Fluid Calprotectin Level as a Diagnostic Marker of Spontaneous Bacterial Peritonitis in Cirrhotic Patients

Afifi¹,

Abdelrahman²,

Osman³

et al. 2022

The Egyptian Journal of Hospital Medicine

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Background: Spontaneous bacterial peritonitis (SBP) is the infection of pre-existing ascitic fluid without evidence of a secondary infection. Objective: To evaluate ascitic fluid calprotectin as a diagnostic marker of spontaneous bacterial peritonitis in cirrhotic patients. Patients and Methods: This study was conducted on 50 cirrhotic patients with ascites. Patients were divided into 2 groups: Group (I): Included 40 cirrhotic patients with SBP on the basis of polymorphonuclear leukocytes (PMN) count in the ascitic fluid ≥250 cells/μL in the absence of secondary peritonitis, irrespective of ascitic fluid culture results, Group (II): Included 10 cirrhotic patients with ascites but without SBP (control group). Results: There was a statistically significant difference between the two studied groups regarding hemoglobin (Hb) (P=0.006), white blood cells (WBCs) (P=0.015), platelet count (P>0.001), C-reactive protein (CRP) (P=0.001) and bilirubin (P=0.013). There was also significant difference between the two studied groups regarding ascitic fluid analysis parameters; as ascitic lactate dehydrogenase (LDH) and PMN count were significantly higher in SBP group (P<0.001, for both). Ascitic fluid calprotectin was significantly higher in SBP group compared to non-SBP group (26.3 ng/ml (6.5 -75) vs. 15 ng/ml (6.5-33); P=0.013). Ascitic calprotectin was significant at a cutoff level of 18 ng/ml with a sensitivity of 90% and 70% specificity for diagnosing SBP with an area under the curve (AUC) = 0.835). Conclusion: Ascitic fluid calprotectin could be used to serve as a convenient reliable diagnostic marker for SBP in cirrhotic patients with ascites.

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Section: Discussionsupporting

confidence: 91%

Ascitic Fluid Calprotectin Level as a Diagnostic Marker of Spontaneous Bacterial Peritonitis in Cirrhotic Patients

Afifi¹,

Abdelrahman²,

Osman³

et al. 2022

The Egyptian Journal of Hospital Medicine

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“…In line with our findings, Rasmy et al (15) highlighted that (HB, AST, Albumin, TP, bilirubin, creatinine, and urea) were insignificantly different between both studied groups. Parallel to our results, Abdel Rahman et al (18) noted that no substantial variation was existed among SBP group and the group without SBP regarding ( HB, AST, Albumin, TP, bilirubin, and creatinine).…”

Section: Discussionsupporting

confidence: 89%

Ascitic Fluid Calprotectin as an Accurate Diagnostic Marker for Spontaneous Bacterial Peritonitis

Mohamed,

Yousef,

Khodeary

et al. 2024

Sohag Medical Journal

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Background: Calprotectin is an acute-phase inflammatory protein secreted by polymorphonuclear leucocytes (PMNL). It is frequently employed in clinical practice for the diagnosis and monitoring of inflammatory bowel diseases. The objective of this work was to assess the usage of calprotectin that found in ascitic fluid as a diagnostic indicator for spontaneous bacterial peritonitis (SBP). Methods: This cross-sectional laboratory-based work was conducted on 50 individuals, diagnosed with cirrhotic-induced ascites with no laboratory or clinical findings of SBP for group 1 and diagnosed with cirrhotic-induced ascites with SBP for group 2. SBP was identified depending on a positive bacterial ascitic fluid culture, an elevated count of PMNLs in the ascites (>250 cells/mm3), and the lack of any infection originating from inside the abdomen. Results: Protein, serum ascites albumin gradient (SAAG), WBCs, PMNL, calprotectin, color of ascitic fluid, number of individuals with yellow, whitish color ascitic fluid, culture, number of patients with klebsiella, pseudomonas, E-coli, streptococcus, total leukocytic count (TLC), Alanine transaminase (ALT), International normalized ratio (INR), and C-reactive protein (CRP)had been substantially elevated in the SBP group contrasted to the group without SBP (P < 0.001). Platelets had been substantially reduced in the SBP group contrasted to non-SBP group (P-value = 0.013). The cut off point value of calprotectin 5.045 showed 89% sensitivity and 86% specificity (P-value <0.001). In multilinear regression, PMNL, and calprotectin were significant predictors of SBP (P ≤ 0.05). Conclusions: The levels of ascitic calprotectin were markedly raised in the group with SBP contrasted to the group without SBP. Furthermore, there was a strong association between ascitic calprotectin levels and the established diagnostic criterion for SBP, which is the presence of PMNLs of 250 cells/mm3 or higher. Consequently, it may serve as a dependable and satisfactory diagnostic indicator for accurately identifying SBP. Furthermore, there is a direct correlation between the amount of ascitic calprotectin and the severity of liver damage.

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“…However, there was no statistically significant difference in serum albumin or alanine aminotransferase readings across the groups, although there was a statistically significant difference in aspartate aminotransferase (AST). Furthermore, our findings are consistent with those of Abdel Rahman et al [21], who found that when 80 patients with liver cirrhosis were separated into two equal groups, with and without SBP, the mean values of AST and ALT did not differ substantially between the two groups.…”

Section: Popoiag Et Al [16]supporting

confidence: 92%

“…Patients in the SBP group had significantly greater blood creatinine and urea than patients in the non-SBP group in terms of kidney function tests. Our findings are consistent with those of Metwally et al [15] and Popoiag et al [16], who found that patients in the SBP group had significantly higher serum creatinine than those in the nonSBP group, but not with those of Abdel Rahman et al [21], who found creatinine values to be similar in both groups.…”

Section: Popoiag Et Al [16]supporting

confidence: 92%

Neutrophil to Lymphocyte Ratio as a Predictor for Spontaneous Bacterial Peritonitis in Patients with Cirrhotic Ascites

Shwighy

Gomaa

Alnaggar

et al. 2022

Zagazig University Medical Journal

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Background: The most prevalent infection in cirrhotic individuals is spontaneous bacterial peritonitis (SBP). Acute GI bleeding, a history of SBP, or low ascetic fluid protein contents are all risk factors for the development of SBP in cirrhotic individuals. The purpose of this study was to see if the neutrophil-tolymphocyte ratio (NLR) could predict spontaneous bacterial peritonitis in individuals with liver cirrhosis. Patients and methods: This prospective, casecontrol and observational study was conducted at Internal Medicine Department, Zagazig University Hospitals during the period from June 2021 to March 2022.The study included 100 cirrhotic patients. The patients were divided into two groups: Group I included 50 cirrhotic patients with SBP (case group) and group II included 50 cirrhotic patients without SBP (control group). Neutrophil to lymphocyte ratio was calculated for all patients. Results: In this study, there was statistically significant difference between the two studied groups in neutrophil count, lymphocyte count and increased neutrophil to lymphocyte ratio (group 1 had increased neutrophils and decreased lymphocytes than group 2). Conclusion: We can conclude the clinical utility of NLR as a biomarker predictive factor in the occurrence of spontaneous bacterial peritonitis (SBP) .

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Ascitic calprotectin as a useful marker in the diagnosis of spontaneous bacterial peritonitis in adults

Cited by 7 publications

References 20 publications

Ascitic Fluid Calprotectin Level as a Diagnostic Marker of Spontaneous Bacterial Peritonitis in Cirrhotic Patients

Ascitic Fluid Calprotectin Level as a Diagnostic Marker of Spontaneous Bacterial Peritonitis in Cirrhotic Patients

Ascitic Fluid Calprotectin as an Accurate Diagnostic Marker for Spontaneous Bacterial Peritonitis

Neutrophil to Lymphocyte Ratio as a Predictor for Spontaneous Bacterial Peritonitis in Patients with Cirrhotic Ascites

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