scholarly journals The validity of Triggering Receptor Expressed on Myeloid Cells (TREM-1) in diagnosis of Spontaneous Bacterial Peritonitis in cirrhotic patients

QJM ◽  
2020 ◽  
Vol 113 (Supplement_1) ◽  
Author(s):  
W Abdelmonsef ◽  
N A Abdelkader ◽  
G A Ismail ◽  
M M Elgaafary ◽  
Y A Abdelrazek
Keyword(s):  
Liver Disease ◽  
Chronic Liver Disease ◽  
Ascitic Fluid ◽  
Spontaneous Bacterial Peritonitis ◽  
Chronic Liver ◽  
Statistical Significant Difference ◽  
Bacterial Peritonitis ◽  
Significant Difference ◽  
Cirrhotic Patients ◽  
The Mean

Abstract Background Spontaneous bacterial peritonitis (SBP) is a serious complication in cirrhotic patients with ascites. Without early antibiotic treatment, this complication is associated with a 30-50% mortality rate. Recently we have evaluated the validity and utility of ascitic fluid triggering receptors expressed on myeloid cells-1 (TREM-1) levels for the diagnosis of SBP. Patients and Methods This was a Prospective case control study conducted on 60 patients with chronic liver disease and ascites divided into two group, group 1 (control) 30 patients without SBP and group 2 (SBP) 30 patients, admitted to the Tropical Medicine Department with ascites due to chronic liver disease. All patients were subjected to full history taking and clinical examination full laboratory investigations including complete blood picture liver and renal profiles, C reactive protein, viral markers, abdominal ultrasound, UGI endoscopy and ascitic fluid sampling for biochemical testing, total and differential cell count, microbiological culture and TREM-1 level. Results There was high statistical significant difference between the two groups in the base level of TREM-1 in which the mean was 1280 pg/ml (1136.9) with level range between (580---4500pg/ml) in SBP versus mean 129.9 pg/ml (51.9) with level range between (60-250pg/ml) in the control group. Also there was a statistical significant difference in the level of TREM-1 before and after treatment in the SBP patients in which the mean of TREM-1 before treatment was 1280.6 pg/ml (1136.9) with level range between (580-4500pg/ml) versus mean 376.2 pg/ml (78.4) and level range between (260-560 pg/ml) after the treatment. Conclusion our data indicate that the measurement of ascitic fluid TREM-1 is rapid, easy and valid test in the diagnosis and follow up of chronic liver disease patients with SBP.

scholarly journals Evaluation of diagnostic accuracy of C-Reactive protein as a biomarker of spontaneous bacterial peritonitis in patients having decompensated chronic liver disease.

2021 ◽  
Vol 28 (10) ◽  
pp. 1438-1442
Author(s):  
Kapeel Raja ◽  
Rizwan Saeed Kiyani ◽  
Sadia Rehman ◽  
Abdul Rashid ◽  
Sanjay Kumar ◽  
...  
Keyword(s):  
Liver Disease ◽  
Diagnostic Accuracy ◽  
Chronic Liver Disease ◽  
Ascitic Fluid ◽  
Predictive Value ◽  
Spontaneous Bacterial Peritonitis ◽  
Chronic Liver ◽  
C Reactive Protein ◽  
Bacterial Peritonitis ◽  
Reactive Protein

Objective: The objective of this study was to evaluate the diagnostic accuracy of C Reactive Protein (CRP) in diagnosing spontaneous bacterial peritonitis (SBP) in patients with decompensated chronic liver disease. Study Design: Cross Sectional study. Setting: Department of Medicine Sheikh Khalifa Bin Zayed Hospital Rawalakot Azad Kashmir. Period:  Feb 2018 to Dec 2018. Material & Methods: One hundred subjects with decompensated liver disease were recruited in this study after fulfilling inclusion criteria. The patients’ medical record number, age and gender was recorded upon admission. Baseline investigations including complete blood count, urine examination and chest X ray were done. Abdominal ultrasound was performed for detecting the presence of ascitic fluid. SBP was diagnosed if > 250 mm3 neutrophils are detected in the ascitic fluid. Serum CRP was detected and reported in mg/L. Results: SBP was detected in 32.8% of the patients having decompensated chronic liver disease. CRP levels were > 29.5mg/L in 36% of the patients while in 64% patients the CRP levels were < 29.5mg/L. The sensitivity of CRP for the diagnosis of SBP was calculated as 83.61% while the specificity was calculated as 87.2%. A positive predictive value was estimated as 76.12% and a negative predictive value was 91.59% while the diagnostic accuracy was calculated as 86.02% from the given data. Conclusion: CRP is a reliable diagnostic biomarker for spontaneous bacterial peritonitis in subjects having complications of chronic liver disease.

scholarly journals Prevalence and Short Term Outcome of Spontaneous Bacterial Peritonitis of Known Chronic Liver Disease Patients

2015 ◽  
Vol 27 (1) ◽  
pp. 15-19 ◽  
Author(s):  
Mohammad Ismail ◽  
Mohammad Anisur Rahman
Keyword(s):  
Liver Disease ◽  
Chronic Liver Disease ◽  
Ascitic Fluid ◽  
Spontaneous Bacterial Peritonitis ◽  
Chronic Liver ◽  
Medical Emergency ◽  
P Value ◽  
Prospective Longitudinal Study ◽  
Bacterial Peritonitis ◽  
Prospective Longitudinal

Spontaneous bacterial peritonitis (SBP) is an infection of ascitic fluid occurring in the absence of a contiguous source of infection characterized by symptoms of fever, abdominal pain, rebound tenderness, encephalopathy. It may develope in hospitalized patients and mortality rate is significantly high. To determine the prevalence of SBP in chronic liver disease with ascites and to establish that SBP is the cause of higher mortality than non SBP, a prospective longitudinal study was carried out in patients attending in the inpatient Department of Gastroenterology of Bangladesh Institute of Research and Rehabilitation in Diabetes, Endocrine and Metabolic Disorder Hospital(BIRDEM), Bangabandhu Sheikh Mujib Medical University(BSMMU), Dhaka Medical College Hospital(DMCH), Dhaka from March 2010 to September 2010. Among the 60 patients the most common age group was the 46-55 years. In physical finding below average body build was found in 48 (80.0%) cases. Malnutrition was found in 48(80.0%) cases. Per abdominal finding liver was not palpable in 54 (90.0%) cases. Shifting dullness was found in 59 (98.3%) cases. Fluid thrill was detected in 57 (95.0%) cases. It was found that SBP were developed in 11(18.3%) cases and remaining 49(81.7%) case were non SBP, which were higher than SBP. Organism of culture of ascitic fluid in SBP patients (n=11) were E. coli and Pseudomoas spp found in 2(18.2%) cases, the rest 6(54.5%) cases shows no growth. Among 11 SBP patients improvement occurred in 5(45.5%) cases and the rest 6(54.5%) cases died p value <.001. SBP is medical emergency, prompt management and prophylactic antibiotics are essential to reduce mortality.Medicine Today 2015 Vol.27(1): 15-19

scholarly journals TOLAK UKUR FUNGSI HATI BERDASARKAN DERAJAT FIBROSIS PENYAKIT HATI KRONIS (Liver Function Parameters based on Degree of Liver Fibrosis in Chronic Liver Disease)

2018 ◽  
Vol 21 (1) ◽  
pp. 57
Author(s):  
Rahmafitria Rahmafitria ◽  
Mutmainnah Mutmainnah ◽  
Ibrahim Abdul Samad
Keyword(s):  
Liver Disease ◽  
Liver Fibrosis ◽  
Liver Function ◽  
Chronic Liver Disease ◽  
Total Bilirubin ◽  
Chronic Liver ◽  
Low Degree ◽  
Significant Difference ◽  
The Mean ◽  
High Degree

Evaluating the degree of liver fibrosis degree is invasive as well as uncomfortable, therefore, non invasive examinations such as liverfunction tests and elastography (Fibro Scan) as a predictor‘s device of liver fibrosis degree are necessary. The aim of this study was toknow the differences of liver function parameters based on the fibrosis degree in patients with chronic liver disease. This study was a crosssectional design using data from chronic liver disease patients treated at the Dr. Wahidin Sudirohusodo Hospital. The elasticity of the liverwas measured using a fibro scan device during June 2010–July 2011. The analysis was carried out by ANOVA test on various parametersof liver function particularly on the fibrosis degree in chronic liver disease. In this study PT, albumin, total bilirubin and platelet countshowed a significant difference of 0.019, 0.009, 0.017 and 0.000 respectively. The mean values of PT and total bilirubin were significantlyhigher in the high degree of fibrosis compared to those with medium and low degree of fibrosis in the chronic liver disease patients. Basedon this study, the mean albumin levels and platelet count were significantly lower in the high degree of fibrosis compared with the mediumand low degree of fibrosis, however, no significant differences in AST, ALT, APTT and GGT were found.

Prevalence and Risk Factors for Unsuspected Spontaneous Ascitic Fluid Infection in Cirrhotics Undergoing Therapeutic Paracentesis in an Outpatient Clinic

2021 ◽  
Vol 15 (11) ◽  
pp. 3470-3473
Author(s):  
Muhammad Omar Khan ◽  
Muhammad Ikram Shah ◽  
Muhammad Imran ◽  
Shazia Siddiq ◽  
Narindar Kumar ◽  
...  
Keyword(s):  
Liver Disease ◽  
Hepatitis C ◽  
Hepatitis B ◽  
Fatty Liver ◽  
Ascitic Fluid ◽  
Fatty Liver Disease ◽  
Spontaneous Bacterial Peritonitis ◽  
Bacterial Peritonitis ◽  
Cirrhotic Patients ◽  
Aseptic Conditions

Background and Aim: Ascites is a common complication of liver cirrhosis, making patients more vulnerable to infectious diseases such as spontaneous bacterial peritonitis. There hasn't been much research done on infectious ascitic fluid in asymptomatic patients. The purpose of the study was to find out the infectious asymptomatic ascitic fluid incidence and risk factors in liver cirrhotic patients. Materials and Methods: This cross-sectional study was conducted on 76 cirrhotic patients who underwent therapeutic paracentesis between September 2020 and February 2021 in an outpatient department of Jinnah Medical College, Peshawar. An 18-G catheter was used to collect ascitic fluid under strict aseptic conditions. Total and differential leucocyte counts, as well as total protein and albumin levels, were measured. The fluid was injected for bacterial culture of aerobic type and anaerobic blood culture bottles (10 mL each) under strict aseptic conditions. Individuals with abdominal pain, recent gastrointestinal bleeding, fever, SBP previous history, hepatic encephalopathy, impaired renal function, and treatment with antibodies were excluded. Written informed consent and ethical approval were taken prior to study conduction. Demographic details, liver disease severity, and etiology were noted along with laboratory technique-based biochemical tests, ascitic fluid count, and culture. SPSS version 20 was used for data analysis. Results: A total of 192 paracenteses were done on 76 liver cirrhosis patients with an average of 2.53 per patient. The overall mean age was 43.65±8.7 years. Of the total 76 patients, 55 (72.4%) were male and 21 (27.6%) were female. The ascites duration for study inclusion was 3 to12 months. Hepatitis B, fatty liver disease, hepatitis C, and drugs were the major causes of cirrhosis among study patients. The prevalence of Hepatitis B, fatty liver disease, hepatitis C, and drugs was 27 (35.5), 23 (30.3%), 11 (14.5%), and 15 (19.7%) respectively. The hepatic encephalopathy and variceal bleeding history were present in 16 (33.3%) and 32 (66.7%) respectively in a total of 48 (63.2%) cirrhosis patients. The class C and child Pugh class had 23 (30.3%) and 53 (69.7%) respectively. Null mortality was found in patients due to infection caused by spontaneous ascitic fluid. Conclusion: Our study found that hepatitis B, fatty liver disease, hepatitis C, and drugs were the major causes of cirrhosis. Asymptomatic ascitic fluid infection was extremely rare in cirrhotic patients who attended an outpatient clinic and underwent therapeutic paracentesis. Additionally, our study found that the peritoneal fluid asymptomatic spontaneous infection is rare among cirrhotic patients undergoing outpatient base therapeutic paracentesis. Further investigation for ascitic fluid analysis's role in such infection without treatment is to be carried out. Keywords: Ascitic fluid; Cirrhosis; Infection; Therapeutic paracentesis; Spontaneous bacterial peritonitis

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