Blood Neutrophil / Lymphocyte Ratio and C –Reactive Protein / Albumin Ratio as Markers of Response for Treatment of Spontaneous Bacterial Peritonitis
Marwa Awad Mustafa *
Department of Tropical Medicine & Infectious Diseases, Faculty of Medicine, Tanta University, Egypt.
Maaly Mohamad Mabrouk
Department of Clinical Pathology, Faculty of Medicine, Tanta University, Egypt.
Sabry Abd Ellatif Abou Saif
Department of Tropical Medicine & Infectious Diseases, Faculty of Medicine, Tanta University, Egypt.
Nadia Muhammad Elwan
Department of Tropical Medicine & Infectious Diseases, Faculty of Medicine, Tanta University, Egypt.
*Author to whom correspondence should be addressed.
Abstract
Background: Spontaneous bacterial peritonitis (SBP) is an acute infection of ascites with the absence of surgically treatable cause and the gold standard method in its diagnosis is the presence of 250 polymorphonuclear neutrophils (PMN) /mm3 or more by diagnostic paracentesis. Blood neutrophil/lymphocytic ratio (NLR) is an applicable, inexpensive, and simple test for inflammation. C-reactive protein/albumin ratio (CAR) is an inflammatory marker used for the diagnosis and follow-up of many diseases and morbidities. We aimed to evaluate the clinical utility of both blood NLR and CAR as applicable, simple and non-invasive tests for SBP follow-up.
Patients and Methods: This study was done on 80 cirrhotic ascitic patients attending the Tropical Medicine Department of Tanta University Hospital. They were subjected to full history taking, clinical examination, laboratory investigations, and ascitic fluid analysis. The patients were divided into two groups according to the results of diagnostic paracentesis into group I: 40 cirrhotic ascitic patients without spontaneous bacterial peritonitis and group II: 40 cirrhotic ascitic patients with spontaneous bacterial peritonitis, and then SBP group were tested after treatment by third-generation cephalosporin for five days for ascitic sample, NLR and CAR.
Results: Both blood NLR and CAR were significantly higher in SBP patients. Also, a significant decrease in both ratios was observed post-treatment with significant positive correlations between both NLR and CAR with ascitic neutrophil count after SBP treatment.
Conclusion: NLR and CAR can be used as quick, cheap, and applicable markers of the response of treatment in SBP patients.
Keywords: Neutrophil / Lymphocyte Ratio - C reactive protein /Albumin Ratio, Markers, Response, Treatment, Spontaneous Bacterial Peritonitis