Role of ascitic endocan levels in the diagnosis of spontaneous bacterial peritonitis in decompensated cirrhosis

Biomarkers ◽  
2020 ◽  
Vol 25 (4) ◽  
pp. 360-366
Author(s):  
Xianmei Wu ◽  
Junli Luo ◽  
Wenxiang Huang ◽  
Bei Jia ◽  
Tao Luo
Keyword(s):  
Spontaneous Bacterial Peritonitis ◽  
Decompensated Cirrhosis ◽  
Bacterial Peritonitis

scholarly journals Ascitic Interleukin 6 Is Associated with Poor Outcome and Spontaneous Bacterial Peritonitis: A Validation in Critically Ill Patients with Decompensated Cirrhosis

2020 ◽  
Vol 9 (9) ◽  
pp. 2865
Author(s):  
Ulrich Mayr ◽  
Marina Lukas ◽  
Mayada Elnegouly ◽  
Christine Vogt ◽  
Ulrike Bauer ◽  
...  
Keyword(s):  
Critically Ill ◽  
Critically Ill Patients ◽  
Interleukin 6 ◽  
Spontaneous Bacterial Peritonitis ◽  
Polymorphonuclear Neutrophils ◽  
Decompensated Cirrhosis ◽  
Diagnostic Ability ◽  
Bacterial Peritonitis ◽  
Rule Out

Decompensated cirrhosis predisposes to infectious diseases and acute-on-chronic liver failure (ACLF) in critically ill patients. Infections like spontaneous bacterial peritonitis (SBP) are frequently associated with multi-organ failure and increased mortality. Consequently, reliable predictors of outcome and early diagnostic markers of infection are needed to improve individualized therapy. This study evaluates the prognostic role of ascitic interleukin 6 in 64 patients with cirrhosis admitted to our intensive care unit (ICU). In addition, we analysed the diagnostic ability of ascitic interleukin 6 in a subgroup of 19 patients with SBP. Baseline ascitic interleukin 6 performed well in predicting 3-month mortality in patients with decompensated cirrhosis (area under curve (AUC) = 0.802), as well as in patients fulfilling ACLF-criteria (AUC = 0.807). Ascitic interleukin 6 showed a moderate prognostic advantage compared with common clinical scores and proinflammatory parameters. Moreover, ascitic interleukin 6 had a sufficient diagnostic ability to detect SBP (AUC = 0.901) and was well correlated with ascitic polymorphonuclear neutrophils in SBP (p = 0.002). Interestingly, ascitic interleukin 6 revealed a high predictive value to rule out apparent infections on admission to ICU (AUC = 0.904) and to identify patients with “culture-positive SBP” (AUC = 0.856). Ascitic interleukin 6 is an easily-applicable proinflammatory biomarker with high prognostic and diagnostic relevance in critically ill patients with liver cirrhosis.

scholarly journals Role of Commiphora Mol Mol and Doxycycline in Prophylaxis of Spontaneous Bacterial Peritonitis in Egyptians Cirrhotic Patients

2015 ◽  
pp. 176-189
Author(s):  
Tarek Mohammed Mostafa ◽  
Osama Mohamed Hassan Ibrahim ◽  
Gamal Ahmed Abd El-Khalek Badra ◽  
Eman Ibrahim Abd El-Kader El-Berri
Keyword(s):  
Spontaneous Bacterial Peritonitis ◽  
Bacterial Peritonitis ◽  
Cirrhotic Patients

Intravenous albumin for spontaneous bacterial peritonitis and renal dysfunction in patients with cirrhosis-short review

2021 ◽  
Vol 5 (1) ◽  
pp. 01-03
Author(s):  
Marilena Stoian
Keyword(s):  
Renal Dysfunction ◽  
Spontaneous Bacterial Peritonitis ◽  
Cost Effective ◽  
Short Review ◽  
Decompensated Cirrhosis ◽  
Optimal Dosage ◽  
Bacterial Peritonitis ◽  
Beneficial Effects ◽  
Albumin Administration

Current clinical guidelines for albumin use in decompensated cirrhosis recommend the use of intravenous albumin infusions for management of ascites-related symptoms and paracentesis (removal of ascitic fluid) and for the management of spontaneous bacterial peritonitis (SBP), renal dysfunction and variceal bleeding. Routine albumin use is not recommended for the management of non-SBP infections. The aim of this review is to improve our understanding of the effects of albumin use in cirrhosis by reviewing the currently available and quantifying the effectiveness of intravenous albumin therapy to prevent specific cirrhosis complications, spontaneous bacterial peritonitis (SBP) and renal dysfunction. Long-term albumin administration to patients with decompensated cirrhosis improves survival, prevents complications, eases the management of ascites and reduces hospitalizations, thus being cost-effective. However, variant results indicate that further investigations are needed, aiming at confirming the beneficial effects of albumin, clarifying its optimal dosage and administration schedule and identify patients who would benefit most from long-term albumin administration.

Study of the role of ascitic fluid lactoferrin levels in the diagnosis of spontaneous bacterial peritonitis

2016 ◽  
Vol 29 (2) ◽  
pp. 464
Author(s):  
Ahmed Elmaaz ◽  
Atef Abulseoud ◽  
Hossam Ibrahim ◽  
Abdallah Essa ◽  
Enas Essa
Keyword(s):  
Ascitic Fluid ◽  
Spontaneous Bacterial Peritonitis ◽  
Bacterial Peritonitis

Role of Albumin Treatment in Patients With Spontaneous Bacterial Peritonitis

2012 ◽  
Vol 10 (3) ◽  
pp. 309-315 ◽  
Author(s):  
Maria Poca ◽  
Mar Concepción ◽  
Meritxell Casas ◽  
Cristina Álvarez–Urturi ◽  
Jordi Gordillo ◽  
...  
Keyword(s):  
Spontaneous Bacterial Peritonitis ◽  
Bacterial Peritonitis

scholarly journals The value of adenosine deaminase (ADA) determination in the diagnosis of tuberculous ascites

1995 ◽  
Vol 37 (5) ◽  
pp. 449-453 ◽  
Author(s):  
Cesar Q. Brant ◽  
Mario R. Silva Jr. ◽  
Erica P. Macedo ◽  
Claudio Vasconcelos ◽  
Natalina Tamaki ◽  
...  
Keyword(s):  
Adenosine Deaminase ◽  
Ascitic Fluid ◽  
Spontaneous Bacterial Peritonitis ◽  
Malignant Ascites ◽  
Bacterial Peritonitis ◽  
Pancreatic Ascites ◽  
Adenosine Deaminase Activity ◽  
Sensitivity Specificity

In order to evaluate the role of the determination of adenosine deaminase activity (ADA) in ascitic fluid for the diagnosis of tuberculosis, 44 patients were studied. Based on biochemical, cytological, histopathological and microbiological tests, the patients were divided into 5 groups: G1 - tuberculous ascites (n = 8); G2 - malignant ascites (n = 13); G3 - spontaneous bacterial peritonitis (n = 6); G4 - pancreatic ascites (n = 2); G5 - miscelaneous ascites (n = 15). ADA concentration were significantly higher in G1 (133.50 ± 24.74 U/l) compared to the other groups (G2 = 41.85 ± 52.07 U/l; G3 = 10.63 ± 5.87 U/l; G4 = 18.00 ± 7.07 U/l; G5 = 11.23 ± 7.66 U/l). At a cut-off value of >31 U/l, the sensitivity, specificity and positive and negative preditive values were 100%, 92%, 72% and 100%, respectively. ADA concentrations as high as in tuberculous ascites were only found in two malignant ascites caused by lymphoma. We conclude that ADA determination in ascitic fluid is a useful and reliable screening test for diagnosing tuberculous ascites. Values of ADA higher than 31 U/l indicate more invasive methods to confirm the diagnosis of tuberculosis.

scholarly journals Update on Peripheral Arterial Vasodilation, Ascites and Hepatorenal Syndrome in Cirrhosis

2000 ◽  
Vol 14 (suppl d) ◽  
pp. 112D-121D ◽  
Author(s):  
Mladen Knotek ◽  
Boris Rogachev ◽  
Robert W Schrier
Keyword(s):  
Hepatorenal Syndrome ◽  
Decompensated Cirrhosis ◽  
Arterial Tree ◽  
Salt Diet ◽  
Bacterial Peritonitis ◽  
Low Salt ◽  
Intrahepatic Portosystemic Shunt ◽  
Peripheral Arterial ◽  
Orally Active

In cirrhosis of the liver, according to the peripheral arterial vasodilation hypothesis, relative underfilling of the arterial tree triggers a neurohumoral response (activation of renin-angiotensinaldosterone system, sympathetic nervous system, nonosmotic release of vasopressin) aimed at restoring circulatory integrity by promoting renal sodium and water retention. Evidence has accumulated for a major role of increased vascular production of nitric oxide as the primary cause of arterial vasodilation in cirrhosis. Ascites is a common complication in cirrhosis. Treatment of ascites consists of a low salt diet with diuretics, and paracentesis together with plasma volume expanders in diuretic-resistant patients. Progression of cirrhosis may result in hepatorenal syndrome, a state of functional renal failure that carries an ominous prognosis. Orthotopic liver transplantation has remained the only curative treatment for patients with advanced liver disease; other modalities such as transjugular intrahepatic portosystemic shunt or vasopressin analogues may serve as a bridge to transplantation. Another complication of decompensated cirrhosis is spontaneous bacterial peritonitis, the incidence of which can be reduced by primary or secondary antibiotic prophylaxis by using orally active antibiotics.

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