A Comparative Study on Ascetic Fluid Biochemical Markers in Cirrhotic Children with and Without Spontaneous Bacterial Peritonitis: A Cross-Sectional Observation
| Author | Gholamreza Kalvandi | en |
| Author | Mahmoud Haghighat | en |
| Author | Naser Honar | en |
| Author | Iraj Shahramian | en |
| Author | Mojtaba Delaramnasab | en |
| Author | Ali Bazi | en |
| Orcid | Naser Honar [0000-0002-7993-2681] | en |
| Orcid | Iraj Shahramian [0000-0002-4134-1405] | en |
| Orcid | Mojtaba Delaramnasab [0000-0002-2958-3671] | en |
| Orcid | Ali Bazi [0000-0003-4872-1352] | en |
| Issued Date | 2019-08-11 | en |
| Abstract | Background: Cirrhotic ascites is frequently complicated with spontaneous bacterial peritonitis (SBP). Objectives: Here, we assessed the diagnostic validity of some inflammatory markers in children with SBP. Methods: This cross-sectional study was performed in the Pediatric Gastroenterology Ward of Namazi hospital of Shiraz. SBP was considered as ≥ 250 polymorphonuclear cell (PMN) /µL ascetic fluid (AF). Results: Out of 150 liver cirrhotic patients with ascites, 41 (27.3%) were diagnosed with SBP. Mean WBC count and PMN per µL of AF were significantly higher in SBP patients than non-SBP (P < 0.0001). The highest specificity for the diagnosis of SBP was recorded for AF smear test (100%). Positive AF smear and culture tests rendered the highest positive predictive values (PPV, 100% and 88.2% respectively). The highest negative predictive value (NPV) was related to AF leukocyte esterase test (94.2%). The highest area under the curve (AUC) for diagnosis of SBP belonged to WBC count (0.956), total cell count (0.817), and LDH concentration (0.814) of AF. A cut off value of 290 WBC per µL AF resulted in respective 95.1% and 88.1% sensitivity and specificity. Trespass of WBC count and lactate dehydrogenase (LDH) level of AF higher than cutoff values (290 cells/µL, and 175 (u/L), respectively) resulted in 82.9%, 92.7%, 81%, and 93.5% sensitivity, specificity, PPV and NPV, respectively. Conclusions: Total cell and WBC counts of AF strongly correlated with ascetic PMN count. Ascetic LDH, alone or in combination with WBC count of AF can be used as a potential surrogate for PMN counts in diagnosis of SBP. | en |
| DOI | https://doi.org/10.5812/compreped.69256 | en |
| Keyword | C-Reactive Protein | en |
| Keyword | Intra-Abdominal Infections | en |
| Keyword | Lactate Dehydrogenase | en |
| Keyword | Peritonitis | en |
| Publisher | Brieflands | en |
| Title | A Comparative Study on Ascetic Fluid Biochemical Markers in Cirrhotic Children with and Without Spontaneous Bacterial Peritonitis: A Cross-Sectional Observation | en |
| Type | Research Article | en |
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