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J Clin Lab Anal. 2016 Nov;30(6):1139-1145. doi: 10.1002/jcla.21994. Epub 2016 May 17.

Ascitic Calprotectin is a Novel and Accurate Marker for Spontaneous Bacterial Peritonitis.

Author information

1
Serviço de Gastrenterologia e Hepatologia, Hospital de Santa Maria, Centro Hospitalar Lisboa Norte, Lisboa, Portugal. Samuelrmfernandes@gmail.com.
2
Serviço de Gastrenterologia e Hepatologia, Hospital de Santa Maria, Centro Hospitalar Lisboa Norte, Lisboa, Portugal.

Abstract

BACKGROUND:

Spontaneous bacterial peritonitis (SBP) is a known complication of advanced cirrhosis and presents a high mortality rate. A polymorphonuclear (PMN) cell count >250/μl in the ascitic fluid is the current gold standard for diagnosing SBP.

AIM:

We evaluated the accuracy of a point-of-care test (POCT) for ascitic calprotectin in diagnosing patients with SBP.

METHODS:

Eighty-eight patients admitted with decompensation of liver cirrhosis were studied including 41 patients (46.6%) with SBP. Ascitic calprotectin was measured using a quantitative POCT developed by Bühlmann® .

RESULTS:

Calprotectin levels correlated with PMN cell count and other inflammatory markers and were significantly higher in patients with SBP. An optimal cutoff of calprotectin above 1.57 μg/ml presented high sensitivity (87.8%), specificity (97.9%), and positive (97.3%) and negative (90.2%) predictive values for diagnosing SBP. Using calprotectin selectively in patients with a serum albumin-ascites gradient above 11 g/l further increased the sensitivity and negative predictive values of the test.

CONCLUSION:

Ascitic calprotectin appears to be a reliable method for diagnosing SBP in patients with liver cirrhosis. It may present an alternative to other conventional diagnostic methods.

KEYWORDS:

ascites; liver cirrhosis; spontaneous bacterial peritonitis

PMID:
27184969
DOI:
10.1002/jcla.21994
[Indexed for MEDLINE]

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