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

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Author(s): Rehab Badawi, Muhammad Nadeem Asghar, Sherief Abd-Elsalam*, Samah A. Elshweikh, Tamer Haydara, Sherein Mohamed Alnabawy, Mahmoud Elkadeem, Walaa ElKhalawany, Samah Soliman, Reham Elkhouly, Shimaa Soliman, Mona Watany, Mai Khalif, Asem Elfert.

Journal Name: Anti-Inflammatory & Anti-Allergy Agents in Medicinal Chemistry

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Abstract:

Background & Aims: Diagnosis of Spontaneous bacterial peritonitis (SBP) depends mainly on ascetic fluid culture which may be negative inspite of clinical suggestion of SBP and high ascetic fluid neutrophilic count. 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), 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. Serum and ascetic fluid amyloid A, ascetic fluid neutrophil, C-reactive protein, and neutrophil-to-lymphocyte ratio were measured in all subjects before start of antimicrobial chemotherapy to infected ones.

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

Conclusion: Amyloid A in serum and ascitic fluid can be considered as good biomarkers for early diagnosis of SBP. [ClinicalTrials.gov Identifier: NCT02759497]

Keywords: Spontaneous bacterial peritonitis (SBP), Serum amyloid A (SAA), C-reactive protein (CRP).

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(E-pub Ahead of Print)
DOI: 10.2174/1871523018666190401154447
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