Use of Fecal Calprotectin as A Predictor of Spontaneous Bacterial Peritonitis in Post Hepatitis C Cirrhotic Egyptian Patients

Background: patients with liver cirrhosis have an increased risk of infections mainly spontaneous bacterial peritonitis, which is present in about 15% of patients with cirrhosis and ascites. This is believed to be mainly due to bacterial translocation (BT) although accurate mechanisms of BT are unknown, SIBO, gut dysmotility, increased intestinal permeability and impaired defense mechanisms are regarded as major risk factors for BT. Objective: to assess the value of fecal calprotectin (FC) as a predictor of SBP in cirrhotic Egyptian patients. Patients and Methods: this study included 75 subjects; they were divided into two groups: 25 cirrhotic subjects with ascites and no SBP as control group and 50 with liver cirrhosis and ascites and an evident SBP, all patients were subjected to full history taking, complete clinical examination and routine laboratory investigations and microbiological analysis of ascitic fluid, stool samples were collected for measuring FC by ELISA. Results: FC showed a highly significant difference (p<0.001) with the median FC in SBP case group higher than median FC of cirrhotic control group and both groups above average normal range, also a colleration emerged between elevated FC and previous history of hepatic encephalopathy in case group. Conclusion: FC was significantly elevated in cirrhotic patients dependant on the severity of liver disease as assessed by Child pugh score and a significant colleration emerged between elevated FC and complications of liver cirrhosis as SBP; So FCC can be used as a useful marker for early prediction and diagnosis of SBP in patient with liver cirrhosis.