Title:Predictive and Prognostic Value of Ascitic Fluid Mannose Binding Lectin in Patients with Spontaneous Bacterial Peritonitis
Volume: 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*
Affiliation:
- Department of Tropical Medicine, Tanta University, Tanta,Egypt
Keywords:
Mannose-binding lectin, liver cirrhosis, spontaneous bacterial peritonitis, complement, liver failure, phagocytosis.
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.
