Quantitative determination of calprotectin in ascites in patients with spontaneous bacterial peritonitis
Published 2020-02-18
Keywords
- calprotectin,
- spontaneous bacterial peritonitis,
- liver cirrhosis
How to Cite
Abstract
Spontaneous bacterial peritonitis (SBP) in patients with liver cirrhosis is a newly developed, spontaneous bacterial infection of sterile ascites fluid, in the absence of intraabdominal sources of infection or malignancy. The most sensitive indicator of diagnosis is when the polymorphonuclear cell count (PMNC) is ≥250 in 1 ml ascites fluid (manual microscopic or automated counting) and/or when a bacterial strain is isolated in microbiological culture. The objectives of our pilot study were to determine the concentration of calprotectin in ascites in patients with SBP and non-SBP with BíœHLMANN Quantum Blue®Reader, whether there was a significant difference between the average values "‹"‹of Turcotte-Pugh II and MELD score and to determine average values for CRP serum and ascites in the studied groups. Materials and methods. This prospective analytical observational pilot study included 30 patients with liver cirrhosis and ascites, divided into two groups, SBP and non-SBP. The quantitative measurement of calprotectin in ascites was performed with the Quantum Blue Calprotectin Ascites (LF-ASC25) test. The test is designed to selectively measure calprotectin antigen (MRP8/14) with direct sandwich immunoassay. The ascites samples were diluted with Chase Buffer 1:5 and after 12 minutes incubation at room temperature, the test line signal intensity and the control line were quantitated with BíœHLMANN Quantum Blue®Reader. The collected data were processed using the SPSS 23 statistical software for Windows. Results. In our study the average value of calprotectin in patients with SBP was 1.4 µg/mL. The lowest value of calprotectin in the study group was recorded in one patient at 0.61 µg/mL, while the highest value was 1.81 µg/mL in four patients. The results showed higher values "‹"‹of calprotectin in ascites in patients with alcoholic liver disease compared to other etiologies. Refractive ascites was reported in 60.0% of the subjects and only one patient (6.7%)was reported with Klepsiella pneumoniae in the microbiological analysis of ascites. According to the Child-Turcotte-PughII classification, all patients in the study group were class C, while the mean MELD score was 29.8±6.14. The difference between the average values of CRP in serum and ascites in patients with SBP was statistically significant compared to non-SBP. Conclusion. The quantitative determination of calprotectin in ascites by the Quantum Blue Calprotectin Ascites (LF-ASC25) assay can be used as an alternative to the determination of PMNC in ascites. SBP occurs in patients with severe hepatic dysfunction calculated according to the Child-Pugh II score and the MELD score. Serum and ascites C-reactive protein values were not significantly elevated in patients with SBP, but were significantly different from non-SBP patients.
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References
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