Evaluation of Ascitic Fluid Calprotectin as an Accurate Marker for Rapid Diagnosis of Spontaneous Bacterial Peritonitis in Patients with Chronic Liver Disease

Background: Spontaneous bacterial peritonitis is the development of an infection of the ascitic fluid in the peritoneum, with no identifiable source of the infection in patients with liver failure. ascitic fluid neutrophil count is more than 250⁄mm3. calprotectin in Ascitic fluid may help in detection of neutrophil count < 250 cells/mm3, it has an effective role in detection of SBP and this will be a rapid treatment and good prognosis. Objectives: Evaluation of the calprotectin in ascitic fluid as rapid marker for diagnosis of SBP. Methodology: our study was done on 40 patients in Hepatology and Gastroenterology Department of Benha University divided into 2 groups 20 patients were SBP group and other 20 patients were non SBP group. 5ml of ascitic fluid was collected from patient in sterile blood culture bottles under complete aseptic condition then cultured on automated blood culture system (Bact/ALERT 3D) .Serum Calprotectin was measured in ascitic fluid by using commercially available quantitative sandwich enzyme-linked immune sorbent assays. Results: SBP was in significant association with higher TLC in AF and higher frequency of positive culture results when compared to non SBP group (p < 0.001 for each).Among all studied cases, median calprotectin level was 0.602 ng/dL. SBP was significantly associated with higher level of calprotectin when compared to non SBP group .Calprotectin showed positive significant correlation with TLC in ascitic fluid. Conclusion: calprotectin in ascitic fluid is an excellent rapid marker for diagnosis of spontaneous bacterial peritonitis in patients with chronic Liver disease.