Abd Ellatif Afifi, M., Kashmoola, M., Hussein, A. (2022). Serum Homocysteine as an Early Diagnostic Marker of Spontaneous Bacterial Peritonitis in Patients with Hepatic Cirrhosis. The Egyptian Journal of Hospital Medicine, 86(1), 266-271. doi: 10.21608/ejhm.2022.211969
Mohamed Abd Ellatif Afifi; Mohammed Zekria Kashmoola; Ahmed Mohamed Hussein. "Serum Homocysteine as an Early Diagnostic Marker of Spontaneous Bacterial Peritonitis in Patients with Hepatic Cirrhosis". The Egyptian Journal of Hospital Medicine, 86, 1, 2022, 266-271. doi: 10.21608/ejhm.2022.211969
Abd Ellatif Afifi, M., Kashmoola, M., Hussein, A. (2022). 'Serum Homocysteine as an Early Diagnostic Marker of Spontaneous Bacterial Peritonitis in Patients with Hepatic Cirrhosis', The Egyptian Journal of Hospital Medicine, 86(1), pp. 266-271. doi: 10.21608/ejhm.2022.211969
Abd Ellatif Afifi, M., Kashmoola, M., Hussein, A. Serum Homocysteine as an Early Diagnostic Marker of Spontaneous Bacterial Peritonitis in Patients with Hepatic Cirrhosis. The Egyptian Journal of Hospital Medicine, 2022; 86(1): 266-271. doi: 10.21608/ejhm.2022.211969
Serum Homocysteine as an Early Diagnostic Marker of Spontaneous Bacterial Peritonitis in Patients with Hepatic Cirrhosis
Background: Spontaneous bacterial peritonitis (SBP) is a term used to describe acute infection of ascites, an abnormal accumulation of fluid in the abdomen, without a distinct or identifiable source of infection. Objective: This study aimed to assess serum homocysteine as a novel reliable early diagnostic marker for spontaneous bacterial peritonitis in patients with hepatic cirrhosis. As the diagnosis of SBP depends primarily on a polymorphonuclear leukocyte cell (PMN) count ≥ 250 mm3, however this method is invasive and sometimes not diagnostic. Patients and methods: This study was conducted on 50 cirrhotic patients with ascites. Patients were divided into 2 groups: Group (A)included30 cirrhotic patients with SBP on the basis of PMN count in the ascitic fluid ≥ 250 cells/μL with or without positive ascitic fluid culture. Group (B)included20 cirrhotic patients with ascites but without SBP (control group). Results: There was a significant difference between the two studied groups regarding C-reactive protein (CRP) (P=0.001) and erythrocyte sedimentation rate (ESR) (P=0.008). There was also significant difference between the two studied groups regarding ascitic fluid analysis parameters; as ascitic glucose and albumin were significantly lower in SBP group (P=0.002 & P=0.027, respectively) while ascitic lactate dehydrogenase (LDH) and PMN count were significantly higher in SBP group (P < 0.001, for both). Serum homocysteine was significantly higher in SBP group compared to non-SBP group (18.43 ± 6.95 vs. 12.13 ± 5.54 μmol/l; P=0.001). Serum homocysteine was significant at a cutoff level of 17.65 μmol/l with a sensitivity of 88.6% and 95.2% specificity for diagnosing SBP with an area under the curve (AUC) = 0.928. Conclusion:Serum homocysteine could serve as a convenient novel and reliable noninvasive early diagnostic marker for
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