Key result
Elevated ascitic fluid calprotectin identifies spontaneous bacterial peritonitis with ~95% sensitivity.
Why the study?
The study was conducted to examine the value of ascitic fluid calprotectin for the diagnosis and prognosis of spontaneous bacterial peritonitis in patients with liver cirrhosis.
Does ascitic fluid calprotectin accurately diagnose and prognosticate spontaneous bacterial peritonitis in patients with liver cirrhosis and ascites?
Observational (n=50)
Does ascitic fluid calprotectin accurately diagnose and prognosticate spontaneous bacterial peritonitis in patients with liver cirrhosis and ascites?
Effect estimate: 95% sensitivity and 90% specificity
p-value: p=0.000
Ascitic fluid calprotectin is a highly sensitive and specific biomarker for the diagnosis and monitoring of spontaneous bacterial peritonitis in patients with liver cirrhosis.
Ascitic calprotectin may aid SBP diagnosis and prognosis in cirrhosis; leaves open clinical adoption pending larger validation studies.
Background: The presence of an elevated absolute polymorphonuclear leukocyte count in the ascitic fluid (>250 cells/mm3) in combination with a positive ascitic fluid bacterial culture is diagnostic of spontaneous bacterial peritonitis. Among the families of calcium-binding proteins known as S100, calprotectin belongs to the subfamily known as calgranulins. Objective: The aim of the current work was to examine the value of ascitic fluid calprotectin for the diagnosis and prognosis of spontaneous bacterial peritonitis in people with liver cirrhosis. Patients and Methods: Between April 2018 and May 2019, 50 Egyptians with liver cirrhosis and ascites were recruited. Forty individuals with spontaneous bacterial peritonitis (SBP) and 10 patients with ascites without SBP were studied. Biochemical, bacterial, and ascitic calprotectin level, as well as diagnostic paracentesis, were performed to all patients. Results: When comparing individuals with cirrhosis and SBP to those without SBP, the level of calprotectin in the ascitic fluid was significantly higher in SBP patients (P= 0.000). Its mean values were statistically significantly reduced after treatment of SBP in comparison to its level before treatment [reduced from 626.75 ± 188.05 to 251.25 ± 223.13 ug/l] with p value 0.000. At a cutoff value of >320 ug/l, ascitic calprotectin may be a possible marker of development of SBP among cirrhotic patients with ascites with 95% sensitivity and 90% specificity. Conclusion: It could be concluded that ascitic fluid calprotectin may be useful in the diagnosis and prognosis of patients with liver cirrhosis and spontaneous bacterial peritonitis.
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Rasmy et al. (2022) conducted an observational in Liver cirrhosis and ascites (n=50). Ascitic fluid calprotectin vs. Patients without spontaneous bacterial peritonitis was evaluated on Diagnosis of spontaneous bacterial peritonitis (95% sensitivity and 90% specificity, p=0.000). Ascitic fluid calprotectin at a cutoff >320 ug/l identified spontaneous bacterial peritonitis with 95% sensitivity and 90% specificity, and levels significantly decreased after treatment (P=0.000).
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