Study of Ascetic Fluid Lactoferrin and Calprotectin as Diagnostic Markers in Cirrhotic Patients with Spontaneous Bacterial Peritonitis

Document Type : Original Article

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Internal Medicine Gastroenterology and Hepatology, Faculty of Medicine, Ain Shams University, Egypt.

Abstract

Background: Liver cirrhosis and ascites patients are at higher risk for spontaneous bacterial peritonitis (SBP), requiring early diagnosis using laboratory procedures. The study investigated the effectiveness of ascetic calprotectin and lactoferrin in diagnosing SBP in liver cirrhosis patients.
Subjects and Methods: This case-control study divided 50 patients with cirrhosis and ascites into two distinct groups: Group A, which included 25 patients without spontaneous bacterial peritonitis (SBP), and Group B, which included 25 patients with SBP. We conducted detailed medical histories, physical exams, lab tests (such as complete blood counts, renal function tests, CRP, HBA1c, and virological markers), echocardiograms (for patients aged 60 and up), pelviabdominal ultrasounds, and ascitic fluid analysis to gather information. We analyzed lactoferrin and calprotectin in ascitic fluid.
Results: The levels of calprotectin and lactoferrin are linked in a good way to white blood cells, ESR, CRP, and ascetic fluid PNL. Conversely, there is a negative correlation between the levels of calprotectin and albumin. Ascetic fluid calprotectin had the greatest AUC = 0.980 with a sensitivity of 92% and a specificity of 96% (p-value <0.001), and its cut-off point was >221. Ascetic fluid lactoferrin had the greatest AUC = 0.980 with a sensitivity of 92% and a specificity of 80% (p-value <0.001), and its cut-off point was >64.5.
Conclusion: Cirrhotic patients with SBP had higher levels of lactoferrin and ascetic fluid calprotectin than cirrhotic individuals without SBP. People with liver cirrhosis can use ascetic fluid lactoferrin and calprotectin as good diagnostic markers to check and diagnose SBP.

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Ain Shams Medical Journal
Volume 76, Issue 1
March 2025
Pages 146-159

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