Ascitic Calprotectin, as a New Marker of Spontaneous Bacterial Peritonitis (SBP)
Kadry Mohamed El Saeed, Engy Yousry El Sayed, Hany Samir Rasmy, Amira Roshdy Mohammed Al Ansary, Fatma Badawy Mansour Al Hajajy- General Medicine
Abstract
Background
Liver cirrhosis results from different mechanisms of live injury that lead to necroinflammation and fibrogenesis; histologically it is characterized by diffuse nodular regeneration surrounded by dense fibrotic septa with subsequent parenchymal extinction and collapse of liver structures, together causing pronounced distortion of hepatic vascular architecture.
Objective
To evaluate the diagnostic role of ascetic fluid calprotectin in cirrhotic patients with spontaneous bacterial peritonitis before and after treatment.
Patients and Methods
This study was designed as a case-control study for evaluation of ascitic calprotectin as a diagnostic & prognostic test for spontaneous bacterial peritonitis. The study was conducted on 50 patients attended internal medicine department in El Dmerdash teaching hospital of Ain Shams University during 2018/2019.
Results
Regarding the ascetic calprotectin after treatment showed decreasing levels correlated with recovery among SBP patients with cut off ≤340 pg/ml had sensitivity 82.5%, specificity 78.0%, PPV 75.0%, NPV 84.8%, accuracy 82.6% in cirrhotic patients with SBP after treatment. Also, the present study found that ascetic calprotectin at cut off value ≤ 780 pg/ml had sensitivity 82.86%, specificity 100%, PPV 100%, NPV 45.5%, accuracy 96.3% in prediction of poor prognosis among SBP cirrhotic patients after treatment.
Conclusion
The best cut-off is level of ascitic calprotectin ≤ 320 pg/ml which had sensitivity 95%, specificity 90%, PPV 74.5%, NPV 81.8%, accuracy 94.1% in prediction of diagnosis of SBP among cirrhotic patients. The best cut-off level of Ascitic calprotectin ng/mL ≤ 780 pg/ml had sensitivity 82.86%, specificity 100%, PPV 100%, NPV 45.5%, accuracy 96.3% in prediction of poor prognosis among SBP cirrhotic patients after treatment.