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Article Type

Original Study

Abstract

Objectives To evaluate the role of mannose-binding lectin (MBL) in cirrhotic patients with and without spontaneous bacterial peritonitis (SBP) and to determine its role in the diagnosis of peritonitis. Background MBL deficiency increases the risk of various infections mostly in immunodeficient conditions. SBP is one of the bacterial infections causing morbidity and mortality under liver cirrhotic patients. Materials and methods A total of 90 individuals (66 male and 24 female with the mean age 52.55 ± 9.90 years) were included: 35 cirrhotic patients with ascites and SBP, 35 cirrhotic patients with ascites and no SBP and 20 apparently healthy persons as a control. The studied groups were subjected to full medical history, clinical examination and measurement of serum level of mannose-binding lectin (sr MBL) by enzyme-linked immunosorbent assay. Cirrhotic patients were subjected to liver function tests, and biochemical and bacteriological examination of ascitic fluid including culture and sensitivity testing was performed for all cirrhotic patients with ascetic fluid total leucocytic count (TLC) greater than 500 cells/mm3. Results sr MBL was significantly lower in group 1 than in group 2 (P < 0.001); sr MBL can predicts SBP with a sensitivity of 71.4% at a cutoff point of 1202.5 ng/ml; also, the sr MBL level was significantly lower in culture-positive ascitic fluid samples than in culture-negative samples (P < 0.05). Patients with positive cultures for Gram-negative isolates had a significantly lower sr MBL than those with Gram-positive isolates (P < 0.05). A negative correlation was found between sr mannose-binding lectin (MBL) and sr albumin, ascitic fluid TLC, and glucose, but a positive correlation was found between sr MBL and aspartate aminotransferase, ascitic fluid albumin, and total protein. Conclusion sr MBL could be considered as a predictive marker for SBP in cirrhotic patients.

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