본문 바로가기
KERD
논문KCI 등재

Ascitic Fluid Calprotectin and Serum Procalcitonin as Accurate Diagnostic Markers for Spontaneous Bacterial Peritonitis

2

조회

0

다운로드

0

인용

0

참고문헌

키워드

초록

Background/Aims: 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 (IL6) 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 nonSBP 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.

Abstract

Background/Aims: 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 (IL6) 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 nonSBP 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.

참고문헌 (30)

  1. Brann OS, "Infectious complications of cirrhosis", Curr Gastroenterol Rep, 3, pp.285~292 (2001)
  2. Mousa N, "Cryptosporidiosis in patients with diarrhea and chronic liver diseases", J Infect Dev Ctries, 8, pp.1584~1590 (2014)
  3. Iqbal J, "Cyclospora cayetanensis: first report of imported and autochthonous infections in Kuwait", J Infect Dev Ctries, 5, pp.383~390 (2011)
  4. Snelling WJ, "Cryptosporidiosis in developing countries", J Infect Dev Ctries, 1, pp.242~256 (2007)
  5. Thuluvath PJ, "Spontaneous bacterial peritonitis:in-hospital mortality, predictors of survival, and health care costs from 1988 to 1998", Am J Gastroenterol, 96, pp.1232~1236 (2001)
  6. Dandona P, "Procalcitonin increase after endotoxin injection in normal subjects", J Clin Endocrinol Metab, 79, pp.1605~1608 (1994)
  7. Viallon A, "Serum and ascitic procalcitonin levels in cirrhotic patients with spontaneous bacterial peritonitis:diagnostic value and relationship to pro-inflammatory cytokines", Intensive Care Med, 26, pp.1082~1088 (2000)
  8. Schäfer BW, "The S100 family of EF-hand calcium-binding proteins: functions and pathology", Trends Biochem Sci, 21, pp.134~140 (1996)
  9. Jung SY, "Serum calprotectin as a marker for disease activity and severity in adult-onset Still’s disease", J Rheumatol, 37, pp.1029~1034 (2010)
  10. Burri E, "Measurement of calprotectin in ascitic fluid to identify elevated polymorphonuclear cell count", World J Gastroenterol, 19, pp.2028~2036 (2013)
  11. Navasa M, "Tumor necrosis factor and interleukin-6 in spontaneous bacterial peritonitis in cirrhosis: relationship with the development of renal impairment and mortality", Hepatology, 27, pp.1227~1232 (1998)
  12. Kim JK, "Changes in serum and ascitic monocyte chemotactic protein-1 (MCP-1) and IL-10 levels in cirrhotic patients with spontaneous bacterial peritonitis", J Interferon Cytokine Res, 27, pp.227~230 (2007)
  13. Moore KP, "Guidelines on the management of ascites in cirrhosis", Gut, 55(6), pp.vi1~vi12 (2006)
  14. Cekin Y, "The role of serum procalcitonin levels in predicting ascitic fluid infection in hospitalized cirrhotic and non-cirrhotic patients", Int J Med Sci, 10, pp.1367~1374 (2013)
  15. Wong F, "Sepsis in cirrhosis: report on the 7th meeting of the International Ascites Club", Gut, 54, pp.718~725 (2005)
  16. Wiest R, "Bacterial translocation (BT) in cirrhosis", Hepatology, 41, pp.422~433 (2005)
  17. Abdel-Razik A, "Platelet indices and inflammatory markers as diagnostic predictors for ascitic fluid infection", Eur J Gastroenterol Hepatol, 26, pp.1342~1347 (2014)
  18. Rimola A, "Diagnosis, treatment and prophylaxis of spontaneous bacterial peritonitis: a consensus document. International Ascites Club", J Hepatol, 32, pp.142~153 (2000)
  19. Schuetz P, "Effect of procalcitonin-based guidelines vs standard guidelines on antibiotic use in lower respiratory tract infections: the ProHOSP randomized controlled trial", JAMA, 302, pp.1059~1066 (2009)
  20. Albillos A, "Ascitic fluid polymorphonuclear cell count and serum to ascites albumin gradient in the diagnosis of bacterial peritonitis", Gastroenterology, 98, pp.134~140 (1990)
  21. Lesińska M, "Procalcitonin and macrophage inflammatory protein-1 beta (MIP-1 beta) in serum and peritoneal fluid of patients with decompensated cirrhosis and spontaneous bacterial peritonitis", Adv Med Sci, 59, pp.52~56 (2014)
  22. Steinbakk M, "Antimicrobial actions of calcium binding leucocyte L1 protein, calprotectin", Lancet, 336, pp.763~765 (1990)
  23. Elbanna A, "Plasma and ascitic fluid level of calprotectin in chronic liver disease malignant and non-malignant", Alexandria Bulletin, pp.647~653 (2008)
  24. Ali AG, "Calprotectin measurement in ascitic fluid: a new test for the rapid diagnosis of spontaneous bacterial peritonitis", Med J Cairo Univ, 81, pp.53~56 (2013)
  25. Park MI, "Tumor necrosis factor-a and interleukin- in ascitic fluid and plasma in spontaneous bacterial peritonitis", Korean J Hepatol, 5, pp.314~321 (1999)
  26. Rodríguez-Ramos C, "Expression of proinflammatory cytokines and their inhibitors during the course of spontaneous bacterial peritonitis", Dig Dis Sci, 46, pp.1668~1676 (2001)
  27. Zhang W, "Serum and ascites levels of macrophage migration inhibitory factor, TNF-α and IL-6 in patients with chronic virus hepatitis B and hepatitis cirrhosis", Hepatobiliary Pancreat Dis Int, 1, pp.577~580 (2002)
  28. Souza MH, "Interleukin 6 concentration in ascitic fluid of cirrhotic patients: relationship with previous episodes of spontaneous bacterial peritonitis", J Gastroenterol, 38, pp.149~152 (2003)
  29. Such J, "Tumor necrosis factor-α, interleukin-6, and nitric oxide in sterile ascitic fluid and serum from patients with cirrhosis who subsequently develop ascitic fluid infection", Dig Dis Sci, 46, pp.2360~2366 (2001)
  30. Odeh M, "Serum levels of tumor necrosis factor-α correlate with severity of hepatic encephalopathy due to chronic liver failure", Liver Int, 24, pp.110~116 (2004)

관련 논문AI추천

Procalcitonin and C-Reactive Protein in the Diagnosis and Prediction of Spontaneous Bacterial Peritonitis Associated With Chronic Severe Hepatitis BLe-Yong Yuan, Ming Wang, Yan Li, Zun-Qiong Ke대한진단검사의학회 · Annals of Laboratory Medicine2013 · 제33권 제6호Clinical Features and Prognosis of Spontaneous Bacterial Peritonitis in Korean Patients with Liver Cirrhosis: A Multicenter Retrospective Study조몽, 허정, 김문영, 김홍수, 박상훈, 박준용, 백순구, 서연석, 안상훈, 엄순호, 임형준, 조세현, 한광협, 한태호, Byung Ik Kim, Ji Young Park, Sung Keun Park거트앤리버 소화기연관학회협의회 · Gut and Liver2009 · 제3권 제3호Predictive factors that influence the survival rates in liver cirrhosis patients with spontaneous bacterial peritonitis김유선, Hee Won Cho, In Hye Cha, Jeong Seop Moon, Jin Nam Kim, Pei Chuan Tsung, Soo Hyung Ryu대한간학회 · Clinical and Molecular Hepatology2013 · 제19권 제2호Diagnostic value of serum procalcitonin and C-reactive protein in discriminating between bacterial and nonbacterial colitis: a retrospective study이유진, Byoung Kuk Jang, Jae Seok Hwang, Jae Yong Lee, Jeong Seok Kim, Jin Wook Lee, Ju Yup Lee, Kwang Bum Cho, So Yeon Lee, Woo Jin Chung영남대학교 의과대학 · Journal of Yeungnam Medical Science2023 · 제40권 제4호자발성 세균성 복막염 환자의 진단에 있어서 시험지봉(Reagent Strips)검사의 유용성김기덕, 김대겸, 김성훈, 서동진, 이영상, 이한주, 임영석, 정영화, 최원범대한간학회 · Clinical and Molecular Hepatology2005 · 제11권 제2005호Clinical impact of healthcare-associated acquisition in cirrhotic patients with community-onset spontaneous bacterial peritonitisCheol-In Kang, Doo Ryeon Chung, Geum-Youn Gwak, Jae-Hoon Song, Jungok Kim, Kyong Ran Peck대한내과학회 · The Korean Journal of Internal Medicine2020 · 제35권 제1호

이 간행물의 다른 논문 (28건)