Can platelets indices and blood neutrophil to lymphocyte ratio be used as predictors for diagnosis of spontaneous bacterial peritonitis in decompensated post hepatitis liver cirrhosis? |
The Egyptian Journal of Immunology Volume 29 (4), October, 2022 Pages: 12–24. www.Ejimmunology.org https://doi.org/10.55133/eji.290402 |
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Muhamad R. Abdel Hammed1, Hussein A. EL-Amien2, Marina Nader Asham2 and Sherein G. Elgendy3
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1Department of Internal Medicine, Hematology Unit, Assiut University Hospitals and South Egypt Cancer Institute Bone Marrow Transplantation Unit, Assiut University, Assiut, Egypt
2Department of Internal Medicine and Gastroenterology Unit, Assiut University Hospitals, Assiut University, Assiut, Egypt
3Department of Medical Microbiology & Immunology, Faculty of Medicine, Assiut University, Assiut, Egypt
Corresponding author: Muhamad R. Abdel Hameed, Department of Internal Medicine, Hematology Unit, Assiut University Hospitals and South Egypt Cancer Institute Bone Marrow Transplantation Unit, Assiut University, Assiut, Egypt. Email: muhammadramadan@aun.edu.eg. dr.muhamadramadan@yahoo.com |
Abstract
Spontaneous bacterial peritonitis (SBP) is most common infection in patients with liver cirrhosis with ascites. SBP is diagnosed by the presence of ≥250 polymorphonuclear leukocyte (PMNL)/mm3 in the ascetic fluid with absence of surgical and treatable causes of intra-abdominal infection. This study intended to evaluate platelet indices and neutrophil to lymphocyte ratio (NLR) as predictors marker of SBP. This study included 106 patients: 53 cirrhotic with SBP, 53 cirrhotic without SBP and 53 sex and age matched normal non cirrhotic controls. The mean platelet volume (MPV), platelet distribution width (PDW), platelet crit (PCT), NLR and C reactive protein (CRP) were compared between study groups. Patients with SBP had significantly higher MPV, PDW, PCT NLR and platelet–lymphocyte ratio (PLR) than patients without SBP (P< 0.001 for all). Patients with SBP had significantly higher MPV, PDW, PCT NLR and PLR than the control group (P< 0.001). MPV, PDW, PCT, PLR, and NLR had positive significant correlations with CRP and ascetic fluid PMNL (P< 0.001). In conclusion, our study findings indicated that platelet indices in cirrhotic patients may be novel, simple, low-cost, non-invasive, and valuable diagnostic marker for diagnosis of SBP. They could be considered reliable and surrogate marker for PMNL.
Keywords: MPV, NLR, PLR, PDW, PCT, SBP, ascetic fluid, diagnostic marker, liver cirrhosis.
Date received: 23 May 2022; accepted: 29 June 2022
PMID: 36197150
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