title: Ascitic Fluid Calprotectin and Serum Procalcitonin as Accurate Diagnostic Markers for Spontaneous Bacterial Peritonitis.
abstract: OBJECTIVE
  The diagnosis of spontaneous bacterial peritonitis (SBP) is based on a polymorphonuclear leukocytes (PMNs) exceeding 250/μL in ascitic fluid. The aim of the study was to evaluate serum procalcitonin and ascitic fluid calprotectin as accurate diagnostic markers for detecting SBP.
  
  
  METHODS
  Seventy-nine patients with cirrhotic ascites were included. They were divided into a SBP group, including 52 patients, and a non-SBP group of 27 patients. Serum procalcitonin, ascitic calprotectin, and serum and ascitic levels of tumor necrosis factor α (TNF-α) and interleukin 6 (IL- 6) were measured using an enzyme-linked immunosorbent assay.
  
  
  RESULTS
  Serum procalcitonin and ascitic calprotectin were significantly higher in SBP patients than in non-SBP patients. Significant increases in both serum and ascitic levels of TNF-α and IL-6 were observed in SBP patients versus non- SBP patients. At a cutoff value of 0.94 ng/mL, serum procalcitonin had 94.3% sensitivity and 91.8% specificity for detecting SBP. In addition, at a cutoff value of 445 ng/mL, ascitic calprotectin had 95.4% sensitivity and 85.2% specificity for detecting SBP. Both were positively correlated with ascitic fluid proteins, PMN count, TNF-α, and IL-6.
  
  
  CONCLUSIONS
  According to our findings, determination of serum procalcitonin levels and ascitic calprotectin appears to provide satisfactory diagnostic markers for the diagnosis of SBP.
authors.affiliation: Department of Tropical Medicine, Mansoura University, Mansoura, Egypt.
authors.forename: Ahmed
authors.initials: A
authors.lastname: Abdel-Razik
authors.affiliation: Department of Tropical Medicine, Mansoura University, Mansoura, Egypt.
authors.forename: Nasser
authors.initials: N
authors.lastname: Mousa
authors.affiliation: Department of Tropical Medicine, Mansoura University, Mansoura, Egypt.
authors.forename: Dina
authors.initials: D
authors.lastname: Elhammady
authors.affiliation: Department of Clinical Pathology, Mansoura University, Mansoura, Egypt.
authors.forename: Rania
authors.initials: R
authors.lastname: Elhelaly
authors.affiliation: Department of Clinical Pathology, Mansoura University, Mansoura, Egypt.
authors.forename: Rasha
authors.initials: R
authors.lastname: Elzehery
authors.affiliation: Department of Endemic Diseases and Gastroenterology, Aswan University, Aswan, Egypt.
authors.forename: Sherif
authors.initials: S
authors.lastname: Elbaz
authors.affiliation: Department of Internal Medicine, Faculty of Medicine, Mansoura University, Mansoura, Egypt.
authors.forename: Mohamed
authors.initials: M
authors.lastname: Eissa
authors.affiliation: Department of Medical Microbiology and Immunology, Mansoura University, Mansoura, Egypt.
authors.forename: Niveen
authors.initials: N
authors.lastname: El-Wakeel
authors.affiliation: Department of Medical Microbiology and Immunology, Mansoura University, Mansoura, Egypt.
authors.forename: Waleed
authors.initials: W
authors.lastname: Eldars
mesh_terms: D000368:Aged; D001202:Ascitic Fluid / Q000737:chemistry*; D001424:Bacterial Infections / Q000175:diagnosis* / Q000382:microbiology; D015415:Biomarkers / Q000032:analysis; D002116:Calcitonin / Q000097:blood*; D004797:Enzyme-Linked Immunosorbent Assay; D005260:Female; D006801:Humans; D015850:Interleukin-6 / Q000032:analysis; D039841:Leukocyte L1 Antigen Complex / Q000032:analysis*; D008103:Liver Cirrhosis / Q000097:blood / Q000378:metabolism* / Q000382:microbiology; D008297:Male; D008875:Middle Aged; D010538:Peritonitis / Q000175:diagnosis* / Q000382:microbiology; D012016:Reference Values; D012680:Sensitivity and Specificity; D014409:Tumor Necrosis Factor-alpha / Q000032:analysis
chemical_list: D015415:Biomarkers; C508600:IL6 protein, human; D015850:Interleukin-6; D039841:Leukocyte L1 Antigen Complex; D014409:Tumor Necrosis Factor-alpha; D002116:Calcitonin
keywords: Calprotectin; Interleukin-6; Procalcitonin; Spontaneous bacterial peritonitis; Tumor necrosis factor-alpha