Serum C-Reactive Protein in Children with Liver Disease and Ascites
Gholamreza Kalvandi1, Naser Honar2, Bita Geramizadeh3
1Department of Pediatrics, Ilam University of Medical Sciences, Ilam, IR Iran.
Insights
Serum C-reactive protein (CRP) is a highly sensitive and specific marker for diagnosing spontaneous bacterial peritonitis (SBP) in children with cirrhosis. This diagnostic tool aids in identifying SBP in pediatric liver disease patients.
Area of Science:
- Pediatric Gastroenterology
- Hepatology
- Infectious Diseases
Background:
- Diagnosing peritonitis in children with cirrhosis is clinically significant.
- Spontaneous bacterial peritonitis (SBP) is a serious complication of liver disease in children.
Purpose of the Study:
- To evaluate serum C-reactive protein (CRP) levels as a diagnostic marker for SBP in pediatric patients with liver disease.
- To determine the accuracy, sensitivity, and specificity of CRP in diagnosing SBP in this population.
Main Methods:
- A study involving 150 children with liver disease and ascites was conducted.
- Patients were classified into SBP and sterile ascites groups based on ascitic fluid polymorphonuclear cell (PMN) count.
- Serum CRP levels were measured, and diagnostic performance of CRP for SBP was assessed.
Main Results:
- Serum CRP levels were significantly higher in children with SBP (36.89 ± 23.43) compared to those without SBP (21.59 ± 15.43).
- CRP demonstrated high diagnostic accuracy, with sensitivity of 69.23% and specificity of 90.25% for SBP diagnosis.
- The area under the curve (AUC) for CRP in diagnosing SBP was 0.94, indicating strong diagnostic capability.
Conclusions:
- Serum C-reactive protein (CRP) is a valuable and reliable biomarker for the diagnosis of SBP in children with cirrhosis.
- CRP offers high sensitivity and specificity, aiding in the early and accurate detection of SBP in pediatric liver disease.
Background:
The diagnosis of peritonitis as a complication of cirrhosis is an important clinical problem.
Objectives:
The aim of this study was to evaluate serum C-reactive protein levels as a diagnostic factor for spontaneous bacterial peritonitis (SBP) in child patients with liver disease.
Methods:
In this study, 150 children diagnosed with liver disease and ascites upon admission to Nemazee Teaching Hospital (Shiraz, Iran) were examined. Patients were divided into spontaneous bacterial peritonitis and sterile ascetic fluid groups according to the PMN count ≥ 250/mm3 in the ascetic fluids. Routine laboratory tests were conducted and quantitative C-reactive protein (CRP) levels were measured for all of the patients. Accuracy, sensitivity, and specificity of CRP was evaluated for diagnosis of SBP.
Results:
Of 150 cirrhotic patients, 109 patients presented without SBP (52.29% male, mean age: 5.02 ± 4.49 years) and 41 patients presented with SBP (51.21% male, mean age: 4.71 years). Cell counts, protein levels, albumin levels, and lactate dehydrogenize (LDH) levels of the ascetic fluid and serum samples in the SBP group were higher than the rates for those without SBP (P < 0.05(. The mean ± SD of CRP in the SBP group (36.89 ± 23.43) increased significantly compared to the rate among those without SBP (21.59 ± 15.43, P = 0.001). The percentages for sensitivity and specificity of CRP, the diagnosis of SBP based on the PMN count ≥ 250/mm3, and cultured ascites were 69.23%, 90.25%, 88.43%, and 84.32%, respectively. The areas under the curve of CRP for SBP based on the PMN count ≥ 250/mm3 and cultured ascites was 0.94 (CI 95%: 0.90 to 0.96) and 0.85 (CI 95%: 0.84 to 0.92), respectively (P < 0.001).
Conclusions:
Our study showed that CRP is a marker with high sensitivity and specificity for the diagnosis of SBP in cirrhotic children.
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