A common bacterial infection of ascitic fluid in ascites
due to liver cirrhosis is spontaneous bacterial peritonitis. Human
neutrophil granules release a 24 KDA glycoprotein called neutrophil
gelatinase associated lipocalin (NGAL). (NGAL) is a tissue injury
and infection marker. Aim: The aim of this study was to determine
the amount of NGAL in ascitic fluid in patients with liver cirrhosis
and spontaneous bacterial peritonitis. Methodologies: A total of 85
patients with cirrhotic ascites were included in the study. 42 of them
had SBP. The severity of liver cirrhosis was assessed using the
Child-Pugh score, the Model for End Stage Liver Disease (MELD),
and its update (uMELD) scores. Ascitic fluid samples were collected
for leucocytic count differentiation, albumin, protein, glucose
estimation, and the serum-ascetic albumin gradient. Both patients
had their NGAL levels measured in their ascitic fluid. If the
polymorph-nuclear leucocytic count in ascitic fluid was more than
250/mm3
, SBP was diagnosed. Results: The level of NGAL in
ascitic fluid was significantly higher in patients with SBP. ROC
analysis of ascitic NGAL as a marker for SBP diagnosis revealed: sensitivity of 97.62 percent,
specificity of 97.67 percent, and area under curve (AUC) of 0.974 at a cut-off value of 100.8
(ng/dl). White blood cells, polymorph nuclear cells (PNCs) in ascitic fluid, Child Pugh score,
MELD score and uMELD score all had a negative correlation with NGAL in non SBP group.
Conclusion: In patients with spontaneous bacterial peritonitis, ascitic fluid NGAL may be a
useful diagnostic marker.
|
