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Predictive and Prognostic Value of Ascitic Fluid Mannose Binding Lectin in Patients with Spontaneous Bacterial Peritonitis

[ Vol. 20 , Issue. 2 ]

Author(s):

Amal A. Mohamed, Mohamed Abdelhamid, Naglaa El-Toukhy, Ahmed Sabry, Rania A. Khattab, Dalia Ali El-damasy, Abeer Ahmed, Mahmoud Elkadeem and Sherief Abd-Elsalam*   Pages 196 - 200 ( 5 )

Abstract:


Background: Spontaneous bacterial peritonitis is a common bacterial infection of ascitic fluid, mainly in ascites due to liver cirrhosis. Mannose-binding lectin (MBL) can activate phagocytosis and the complement system. Spontaneous bacterial peritonitis was detected to be higher in MBL deficiency. This study aimed to assess ascitic fluid MBL in liver cirrhosis and spontaneous bacterial peritonitis.

Methods: Ninety patients with cirrhotic ascites were included. Forty five of them had SBP. Child- Pugh score, Model for End Stage Liver Disease (MELD) and its update (uMELD) scores were used to assess the severity of liver cirrhosis. Ascitic fluid samples were obtained for differentiation of leucocytic count, estimation of albumin, protein, glucose, and serum-ascitic albumin gradient. Ascitic fluid levels of MBL were measured for all patients. SBP was documented if polymorphonuclear leucocytic count ≥250/mm in ascitic fluid.

Results: Ascitic fluid MBL level was significantly lower in patients with SBP. MBL had a significant negative correlation with ascitic total leukocytic count (TLC), also with serum creatinine, bilirubin, PT, INR and MELD score among SBP patients. However, it had a significant positive correlation with ascitic protein and with platelets. According to multivariate analysis, fever, TLC, platelets, creatinine, MBL, glucose and polymorphs were independent predictors for SBP development.

Conclusion: Ascitic fluid MBL could be a good predictive and prognostic marker in patients with cirrhosis and spontaneous bacterial peritonitis.

Keywords:

Mannose-binding lectin, liver cirrhosis, spontaneous bacterial peritonitis, complement, liver failure, phagocytosis.

Affiliation:

Department of Biochemistry, National Hepatology and Tropical Medicine Research Institute, Cairo, Department of Hepatology & Gastroenterology and Infectious Diseases, Faculty of Medicine, Benha University, Benha, Department of Hepatology & Gastroenterology and Infectious Diseases, Faculty of Medicine, Benha University, Benha, Department of Hepatology & Gastroenterology and Infectious Diseases, Faculty of Medicine, Benha University, Benha, Department of Microbiology and Immunology, Faculty of Pharmacy, Cairo University, Cairo, Department of Microbiology, Faculty of Pharmacy, Egyptian Russian University, Badr City, Department of Microbiology, Faculty of Medicine, Beni Suef University, Beni Suef, Department of Tropical Medicine, Tanta University, Tanta, Department of Tropical Medicine, Tanta University, Tanta



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