Background and study aim: The most
common infection in decompensated
hepatic patients with cirrhotic ascites is
spontaneous bacterial peritonitis (SBP),
which occurs in the absence of an evident
intra-abdominal source of infection. The
aim of this work is to assess the value of
calprotectin in ascitic fluid in diagnosis of
spontaneous bacterial peritonitis in
patients with liver cirrhosis.
Patients and Methods: In this cross
section study, 80 cirrhotic patients were
divided into (group A) 40 patients with non
SBP and (group B) 40 patients with SBP,
who attended the Hepatology Department
Benha University Hospital. All the patients
were evaluated by thorough history, clinical
examination, laboratory investigations,
ultrasonongraphy, diagnostic paracentesis
with PMNLs count and Calprotectin
which was measured in 1 mL ascetic fluid
by ELIZA.
Results: Calprotectin was high in SBP
group with a highly statistical significant
difference in SBP group compared to non
SBP group so it can serve as a sensitive
and specific diagnostic test for detection
of SBP in cirrhotic patients with ascites.
The sensitivity of the test was 90% with
specificity of 62.5%, PPV of 70.5% and
NPV of 86.5% with the cut-off level were
2.98 ng /ml and the area under the curve
was 0.88.
Conclusion: Ascitic calprotectin reliably
predicts PMN count >250/μL, which may
prove useful in the diagnosis of SBP,
especially with a readily available bedside
testing device. |
