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Amyloid A in Serum and Ascitic Fluid as a Novel Diagnostic Marker of Spontaneous Bacterial Peritonitis

[ Vol. 19 , Issue. 2 ]

Author(s):

Rehab Badawi, Muhammad N. Asghar, Sherief Abd-Elsalam*, Samah A. Elshweikh, Tamer Haydara, Sherein M. Alnabawy, Mahmoud Elkadeem, Walaa ElKhalawany, Samah Soliman, Reham Elkhouly, Shimaa Soliman, Mona Watany, Mai Khalif and Asem Elfert   Pages 140 - 148 ( 9 )

Abstract:


Background: Diagnosis of Spontaneous Bacterial Peritonitis (SBP) depends mainly on ascetic fluid culture which may be negative in spite of the clinical suggestion of SBP and high ascetic fluid neutrophilic count.

Aims: This study aimed to evaluate the biological importance of amyloid A biomarker in both serum and ascetic fluid to diagnose SBP as early as possible and to compare it to other markers (C-reactive protein (CRP), and the neutrophil-to-lymphocyte ratio (NLR)).

Methods: This study included 37 patients with hepatic ascites; twenty-two of them had SBP, and 15 patients did not have SBP. Serum and ascetic fluid amyloid A, ascetic fluid neutrophil, C-reactive protein, and neutrophil-to-lymphocyte ratio were measured in all subjects before the start of antimicrobial chemotherapy to the infected ones.

Results: Both the serum and ascetic fluid amyloid and also, CRP were significantly higher in patients infected with ascetic fluid than others. The cut-off point of serum amyloid A for early detection of SBP was 9.25ug/ml with the high sensitivity and specificity. For ascetic amyloid A, the sensitivity and specificity were 90.09% and 60% at cut-off point 2.85ug/ml, respectively.

Conclusion: Amyloid A in serum and ascitic fluid can be considered as a good biomarker for early diagnosis of SBP.

Keywords:

Ascitic fluid, bacterial infections, C-Reactive Protein (CRP), diagnostic marker, Serum Amyloid A (SAA), Spontaneous Bacterial Peritonitis (SBP).

Affiliation:

Tropical Medicine and Infectious Diseases, Faculty of Medicine, Tanta University, Tanta, Department of Biosciences, Abo Akademi University, 20500 Turku, Tropical Medicine and Infectious Diseases, Faculty of Medicine, Tanta University, Tanta, Internal Medicine Department, Tanta University, Tanta, Internal Medicine Department, Kafr-Elsheikh University, Kafr El- Shaikh, Internal Medicine Department, Tanta University, Tanta, Tropical Medicine and Infectious Diseases, Faculty of Medicine, Tanta University, Tanta, Tropical Medicine and Infectious Diseases, Faculty of Medicine, Tanta University, Tanta, Tropical Medicine and Infectious Diseases, Faculty of Medicine, Tanta University, Tanta, Tropical Medicine and Infectious Diseases, Faculty of Medicine, Tanta University, Tanta, Public Health and Community Medicine, Faculty of Medicine, Menoufia University Menoufia, Clinical Pathology, Faculty of Medicine, Tanta University, Tanta, Tropical Medicine and Infectious Diseases, Faculty of Medicine, Tanta University, Tanta, Tropical Medicine and Infectious Diseases, Faculty of Medicine, Tanta University, Tanta

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