The importance of ascitic fluid Lactoferrin level in management of spontaneous bacterial peritonitis in Egyptian patients with liver cirrhosis / Mohamed Mahmoud Kamal Elsayed ; Supervised Soheir Abdelfattah Abuelfadl , Laila Ahmed Rashed , Mahmoud Mohamed Elnokeety

Thesis (M.Sc.) - Cairo University - Faculty of Medicine - Department of Internal Medicine

Abstract: Spontaneous bacterial peritonitis is a well-known and ominous complication in patients with cirrhosis. Patients with SBP should be started on empiric, broad-spectrum antibiotics immediately after peritoneal fluid is obtained to maximize the patient's chance of survival. The aim of the study:To compare between ascitic fluid Lactoferrin in cirrhotic patients with SBP & those without SBP & to compare ascitic fluid Lactoferrin in patients with SBP before and after antibiotic therapy & to compare ascitic fluid Lactoferrin between both culture positive and culture negative SBP, so that we can early detect SBP specially in suspicious patients (e.g. with hematemesis or hepatic encephalopathy) Subjects & Methods: The study included 150 Egyptian patients with liver cirrhosis & ascites; 100 patients with SBP based upon clinical picture and analysis of ascitic fluid& 50 patients without SBP (controls). The SBP group (Group A): 100 patients with ascitic fluid Polymorph Nuclear cells {u2265} 250 cells/mm3who have not started systemic antibiotic treatment for SBP yet. Ascitic fluid Lactoferrin was measured twice: - First time: Before starting the systemic antibiotic treatment. - Second time: 5-7 days after the start of antibiotic course (3rd generation cephalosporin).Non-SBP group (Group B): 50 patients with ascitic fluid Polymorph Nuclear cells (PMNs) < 250 cells/mm3 (Control group) with no history of SBP. Ascitic Lactoferrin level was measured. Exclusion criteria: 1. Patients who had Hepatocellular Carcinoma (HCC) or malignant ascites excluded by history, laboratory & imaging findings. 2. Patients who had hemorrhagic ascites

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