Open AccessAscitic Calprotectin is a Novel and Accurate Marker for Spontaneous Bacterial Peritonitis
Author(s) -
Fernandes Samuel Raimundo,
Santos Patrícia,
Fatela Narcisa,
Baldaia Cilénia,
Tato Marinho Rui,
Proença Helena,
Ramalho Fernando,
Velosa José
Publication year - 2016
Publication title -
journal of clinical laboratory analysis
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.536
H-Index - 50
eISSN - 1098-2825
pISSN - 0887-8013
DOI - 10.1002/jcla.21994
Subject(s) - spontaneous bacterial peritonitis , calprotectin , medicine , cirrhosis , ascites , gastroenterology , gold standard (test) , decompensation , ascitic fluid , positive predicative value , predictive value , disease , inflammatory bowel disease
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.