A paradoxical role for an acute phase reactant in decompensated cirrhosis

• Published in: Tropical gastroenterology Vol. 36; no. 2; p. 107
• Main Authors: Peter, George, George, Paul Cheruvathoor, Villyoth, Mashhood Padincharepurathu, Bahuleyan, Suthanu, Suraj, Nikhil, Govindaraju, Chethan, Abdul Sathar, Shanid, Sreesh, Srijaya, Narayanan, Premalatha, Kumar, Kattoor Ramakrishnan Vinaya
• Format: Journal Article
• Language: English
• Published: India 01.04.2015
• Subjects: Adult; Aged; Aged, 80 and over; Ascites - blood; Ascites - complications; Bacterial Infections - blood; Bacterial Infections - diagnosis; Bacterial Infections - etiology; C-Reactive Protein - metabolism; Cellulitis - blood; Cellulitis - diagnosis; Cellulitis - etiology; Female; Follow-Up Studies; Humans; Liver Cirrhosis - blood; Liver Cirrhosis - complications; Male; Middle Aged; Peritonitis - blood; Peritonitis - diagnosis; Peritonitis - etiology; Predictive Value of Tests; Prospective Studies; Serum Albumin - metabolism
• ISSN: 0250-636X
• DOI: 10.7869/tg.262

This study aims to determine the predictive power of baseline C-reactive protein (CRP) value in cirrhotic patients with ascites, without overt infection, that might lead to spontaneous bacterial peritonitis (SBP)/ cellullitis. 152 consecutive cirrhotic patients with ascites, without overt infection were included in the study, after measuring the baseline CRP value. All patients were followed up for a duration of one year, or till development of SBP/cellulitis. Baseline CRP was elevated in 76.8% of the patients. Development of infection was observed in 78 (51.3%) patients. SBP was diagnosed in 54 patients, cellulitis was documented in 15 patients. 9 patients had simultaneous SBP and cellulitis Baseline CRP was 10.2 ± 6.34 mg/dL in the group who developed infection, it was 4.81 ± 4.41 mg/dL in the group who did not develop infection (p = 0.002). Baseline CRP > 9.5 mg/dL, serum albumin < 2.8 g/dL and a previous history of infection were independent predictors of developing SBP/cellulitis. Along with low serum albumin and previous history of infection, CRP can be used as a predictive tool for early detection of infection, thus enabling to reduce the morbidity and mortality.