A paradoxical role for an acute phase reactant in decompensated cirrhosis

This study aims to determine the predictive power of baseline C-reactive protein (CRP) value in cirrhotic patients with ascites, without overt infection, that might lead to spontaneous bacterial peritonitis (SBP)/ cellullitis.

152 consecutive cirrhotic patients with ascites, without overt infection were included in the study, after measuring the baseline CRP value. All patients were followed up for a duration of one year, or till development of SBP/cellulitis.

Baseline CRP was elevated in 76.8% of the patients. Development of infection was observed in 78 (51.3%) patients. SBP was diagnosed in 54 patients, cellulitis was documented in 15 patients. 9 patients had simultaneous SBP and cellulitis Baseline CRP was 10.2 ± 6.34 mg/dL in the group who developed infection, it was 4.81 ± 4.41 mg/dL in the group who did not develop infection (p = 0.002). Baseline CRP > 9.5 mg/dL, serum albumin < 2.8 g/dL and a previous history of infection were independent predictors of developing SBP/cellulitis.

Along with low serum albumin and previous history of infection, CRP can be used as a predictive tool for early detection of infection, thus enabling to reduce the morbidity and mortality.