TITLE:
Value of Different Diagnostic Markers in Spontaneous Bacterial Peritonitis in HCV Egyptian Cirrhotic Patients
AUTHORS:
Emad M. El Motasem, Ahmed A. Heikal, Hemmat E. El Haddad, Ahmed Hamdy, Rasha M. Abdel Samie, Heba Sharaf El Din
KEYWORDS:
Spontaneous Bacterial Peritonitis-Serum Lipopolysaccharide Binding Protein-Ascitic Fluid Complement 3-C-Reactive Protein-Ascitic Fluid Culture
JOURNAL NAME:
Open Journal of Gastroenterology,
Vol.5 No.9,
September
8,
2015
ABSTRACT: Background: Spontaneous bacterial peritonitis (SBP) is a life-threatening infection occurring in 8% - 30% of ascitic cirrhotic patients; different laboratory diagnostics play a pivotal role for rapid and effective management of SBP patients. Polymorphonuclear leucocytic (PMNLs) count in Ascitic fluid (AF) is the mainstay for the diagnosis, whereas the diagnostic role of alternative biomarkers is rather controversial. In many studies, serum lipopolysaccharide binding protein (LBP) was elevated and Complement 3 (C3) level was significantly consumed in AF of SBP patients. Objectives: To evaluate the diagnostic value of serum LBP and AF C3 in HCV-cirrhotics with SBP in relation to other well-established serum and AF markers. Patients and Methods: One hundred and twenty patients with HCV-cirrhosis and ascites were enrolled and consented: 50 patients with non-SBP ascites in group A and 70 ascitic patients diagnosed with SBP according to clinical suspicion and PMLs count in AF ≥ 250 cells/mm3 in group B in addition to 15 healthy individuals considered as a control group. Serum LBP, CBC, kidney and liver function tests, CRP, fasting and 2 h PP blood glucose and HCV antibodies were measured. AF samples were sent for C3 level, culture, PMNLs count, LDH, CRP, total proteins and albumin. Results: In patients with SBP, the level of serum LBP was not significantly high (p > 0.05) with best cut off value at 0.4500 and poor AUC (