Background and study aim: The most common infections in decompensated liver cirrhotic ascites patients are cases of spontaneous bacterial peritonitis (SBP), which account for 40%–70% of cases with absence of an evident intraabdominal or surgically treatable source of infection. An ascitec fluid polymorphonuclear (PMN) leucocytes count ≥ 250/ mm3 irrespective of the ascitec fluid (AF) culture result is universally accepted nowadays as the best surrogate marker for diagnosing SBP. Frequently the results of the manual or automated PMN count do not reach the hands of the responsible medical personnel in a timely manner. Therefore, an accurate and convenient method of rapid diagnosis of SBP remains an unmet clinical need. Granulocyte elastase (GE) is a powerful proteolytic enzyme that is released by PMNs when degranulated in infectious processes which could be used indirectly in diagnosis of SBP. This study aims to evaluate the granulocyte elastase enzyme in ascitec fluid in diagnosis of spontaneous bacterial peritonitis.
Patients and methods: This study was conducted on 80 patients with liver cirrhosis and ascites; 40 patients of them without SBP (group A) and 40 patients of them with SBP (group B) who were admitted to the Hepatology, Gastroenterology and Infectious Diseases Department, Benha University Hospital in the period between April 2014 and October 2014. Full history taking, clinical examination and laboratory investigation were done. Ascitic fluid analysis was done including detection of granulocyte elastase level by ELISA.
Results: Granulocyte elastase (GE) was markedly elevated in group B; mean ascitic fluid GE by ELISA (4.1ng|ml±2.8) comparing with group A (0.8±0.7) with high statistically significant (P value |
