Ascitic Fluid Markers Hepcidin, Calprotectin, and Lactoferrin in Early Diagnosis and Follow-up of Spontaneous Bacterial Peritonitis | ||||
| The Medical Journal of Cairo University | ||||
| Article 21, Volume 86, December, December 2018, Page 3543-3549 PDF (479.25 K) | ||||
| Document Type: Original Article | ||||
| DOI: 10.21608/mjcu.2018.60595 | ||||
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| Authors | ||||
| HANAN MADANI, M.D.; TAMER EL-BAZ, M.D.; MOHAMMAD EL-SAYED, M.D.; AHMED CORDIE, M.D.; MAISSA EL-RAZIKY, M.D. | ||||
| The Departments of Clinical & Chemical Pathology* and Endemic Hepatogastroenterology**, Faculty of Medicine, Cairo University | ||||
| Abstract | ||||
| Abstract Background: Spontaneous Bacterial Peritonitis (SBP) is the most serious complication in patients with decompensated liver cirrhosis and ascites. Its diagnosis is based on Polymorph Nuclear Leucocyte (PMNL) count in ascitic fluid >250 cell/mm3, however; SBP occurs at even lower levels, hence the need for early sensitive and specific markers for early detection and prognosis of SBP. Aim of Study: The aim of the study was to assess ascitic fluid Calprotectin, Lactoferrin and Hepcidin as reliable markers for diagnosis and follow-up of SBP. Patients and Methods: Ascitic fluid samples were collected from 88 patients with ascites; 37 with SBP (patients group) and 51 without SBP (control group). Calprotectin, Lactoferrin and Hepcidin levels were measured using Enzyme Linked Immunosorbent assay (ELISA). Results: Calprotectin, Lactoferrin and Hepcidin were significantly higher in patients with SBP than those without SBP (p=0.002, 0.001, 0.029 respectively). The areas under the receiver operator characteristic curve for Calprotectin, Lactoferrin and Hepcidin were (0.695, 0.860 & 0.661 respec-tively) with sensitivity 91.9% for the three markers. Hepcidin showed higher specificity (64.7%) than the other two markers. Calprotectin and Hepcidin decreased significantly after proper antibiotic therapy than before therapy in SBP group (p=0.002 & 0.004 respectively). Conclusion: Ascitic fluid Calprotectin, Lactoferrin and Hepcidin can be used as diagnostic markers of SBP. Calpro-tectin and Hepcidin can be used as markers for follow-up of SBP. Hepcidin was the most specific among them. | ||||
| Keywords | ||||
| SBP – Calprotectin – Lactoferrin – Hepcidin – Ascites | ||||
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