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Updated: Jul 4, 2025
Colon Ascendens Stent Peritonitis CASP - a Standardized Model for Polymicrobial Abdominal Sepsis
Published on: December 18, 2010
Ascites fluid calprotectin level is highly accurate in diagnosing spontaneous bacterial peritonitis: a preliminary
Wisam Sbeit1,2, Basheer Maamoun1,2, Subhi Azzam1
1Department of Gastroenterology, Galilee Medical Center, Nahariya, Israel.
Abstract:
Ascites is the most common complication of liver cirrhosis. Spontaneous bacterial peritonitis (SBP) is a common complication of ascites. The diagnosis is made by an ascitic fluid polymorphonuclear (PMN) cell count of ≥ 250/mm3. However, no other diagnostic test is present for the diagnosis of SBP. The aim of the study present study is to assess the diagnostic yield of ascitic calprotectin in SBP, and to explore whether it can predict disease stage. We performed a single center proof-of-concept prospective study including all patients with cirrhosis and ascites who underwent paracentesis. Overall, 31 patients were included in the study. Eight patients had SBP vs. 23 patients without SBP. Ascitic calprotectin level was 77.4 ± 86.5 μg/mL in the SBP group, as compared to 16.1 ± 5.6 μg/mL in the non-SBP group (P = 0.001). An ascitic calprotectin cut-off value of > 21 μg/mL was associated with sensitivity and specificity of 85.7% and 89.5%, respectively, with ROC of 0.947 (95% CI 0.783 to 0.997, P < 0.0001). Notably, ascitic calprotectin did not had a prognostic value in cirrhosis stage and prognosis. Ascitic calprotectin was highly accurate in the diagnosis of SBP. It can be a serve as adjunct for indefinite cases of SBP.
Insights
Ascitic fluid calprotectin shows high accuracy in diagnosing spontaneous bacterial peritonitis (SBP) in cirrhosis patients. This biomarker can serve as an adjunct diagnostic tool for SBP, especially in unclear cases.
Area of Science:
- Gastroenterology
- Hepatology
- Clinical Diagnostics
Background:
- Ascites is a frequent complication of liver cirrhosis, increasing the risk of spontaneous bacterial peritonitis (SBP).
- Current diagnosis of SBP relies on ascitic fluid polymorphonuclear (PMN) cell count (≥250/mm³), lacking other specific diagnostic tests.
- There is a need for accurate and accessible biomarkers for SBP diagnosis in cirrhotic patients.
Purpose of the Study:
- To evaluate the diagnostic performance of ascitic fluid calprotectin for spontaneous bacterial peritonitis (SBP).
- To determine if ascitic calprotectin can predict disease severity or prognosis in cirrhosis.
- To explore the potential of ascitic calprotectin as an adjunctive diagnostic marker for SBP.
Main Methods:
- A single-center, proof-of-concept prospective study.
- Inclusion of patients with cirrhosis and ascites undergoing paracentesis.
- Measurement of ascitic fluid calprotectin levels and comparison between SBP and non-SBP groups.
Main Results:
- Ascitic calprotectin levels were significantly higher in patients with SBP (77.4 ± 86.5 μg/mL) compared to those without (16.1 ± 5.6 μg/mL) (P=0.001).
- A cut-off value of >21 μg/mL for ascitic calprotectin demonstrated high sensitivity (85.7%) and specificity (89.5%) for SBP diagnosis (ROC 0.947, P<0.0001).
- Ascitic calprotectin did not show prognostic value for cirrhosis stage or patient outcome.
Conclusions:
- Ascitic calprotectin is a highly accurate biomarker for the diagnosis of spontaneous bacterial peritonitis (SBP).
- It can serve as a valuable adjunct diagnostic tool, particularly in cases where SBP diagnosis is uncertain.
- Further research is warranted to validate these findings in larger cohorts.
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