Research Article Open Access Journal of Molecular Biomarkers & Diagnosis J o u r n a l o f M o l e c u l a r B i o m a r k e r s & D i a g n o s i s ISSN: 2155-9929 Amal et al., J Mol Biomark Diagn 2017, 8:5 DOI: 10.4172/2155-9929.1000354 Volume 8 • Issue 5 • 1000354 J Mol Biomark Diagn, an open access journal ISSN:2155-9929 *Corresponding author: Mohammed Ahmed Mohey Eldin Elzahry, Departemnt of Endemic Medicine and Hepatology, Faculty of Medicine, Cairo University, Cairo, Egypt, Tel: +20 2 35676105; E-mail: ma.mohey@cu.edu.eg Received September 24, 2017; Accepted October 01, 2017; Published October 03, 2017 Citation: Amal A, Mahmoud A, Zeinab H, Zeinab A, Eman A, et al. (2017) Mean Platelet Volume is a Promising Diagnostic Marker for Systemic Inflammation in Cirrhotic Patients with Ascitic Fluid Infection. J Mol Biomark Diagn 8: 354. doi: 10.4172/2155-9929.1000354 Copyright: © 2017 Amal A, et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Mean Platelet Volume is a Promising Diagnostic Marker for Systemic Inflammation in Cirrhotic Patients with Ascitic Fluid Infection Abdelmoez Amal 1 , Atalla Mahmoud 2 , Hefny Zeinab 1 , Abdellatif Zeinab 2 , Adel Eman 2 , Abbas Bahaa 3 , Mehrez Mai 4 , Guda Mohamed 5 , Abouelkhair Mahmoud 2 and Elzahry Mohammad AME 2 * 1 Department of Tropical Medicine, Ain Shams University, Cairo, Egypt 2 Department of Endemic Medicine and Hepatology, Faculty of Medicine, Cairo University, Cairo, Egypt 3 Air Force Hospital, Cairo, Egypt 4 National Hepatology and Tropical Medicine Research Institute, Cairo, Egypt 5 Theodore Bilharz Research Institute, Cairo, Egypt Abstract Introduction: Spontaneous bacterial peritonitis (SBP) is the most frequent and life-threatening infection in patients with decompensated liver cirrhosis. Diagnosis should be prompt and treatment must not be delayed until the microbiology results are available. Aims and Methods: The current study was conducted to assess the potential role that MPV may have in the diagnosis of SBP in cirrhotic patients with ascites Three groups were included in the study. Group I (SBP group) included 100 patients with liver cirrhosis and ascites complicated by SBP, group II (non-SBP group) included 98 patients with liver cirrhosis and ascites without SBP and group III included 50 healthy subjects to serve as a control group. Results: ESR, CRP and total leucocytic count (TLC) in ascitic fluid were significantly higher in SBP group compared to non-SBP group (median 37.5 vs. 12, 12 vs. 5 and 530 vs. 60 respectively with p value<0.01). The MPV was significantly higher in SBP group vs. non-SBP group and healthy control group (8.5, 7.9 and 8.3 respectively and P value<0.0001). On constructing ROC curve for the MPV; at a cutoff value of 8.4 fl, MPV had 73% sensitivity and 85.7% specificity for detecting SBP with overall accuracy 79.3%, (AUC=0.84 with negative predictive value (NPV) and positive predictive value (PPV) for MPV of 75.7 and 83.9%, respectively). Regarding ESR; at a cutoff value of 20. Conclusion: MPV is increased in SBP in cirrhotic patients with ascites than the other inflammatory markers. Keywords: MPV; Ascites; Infection Introduction Spontaneous bacterial peritonitis (SBP) is infection of the ascitic fluid with no intra-abdominal source of infection or malignancy. It is one of the most frequent complications in patients with liver cirrhosis and ascites [1]. Ascitic fluid infection is extremely common at the time of hospital admission of a patient with cirrhosis and ascites that requires a diagnostic paracentesis [2]. For SBP diagnosis, the count of polymorphonuclear leucocytes [PMN] in the ascitic fluid obtained by paracentesis must exceed 250 cells/mm 3 Because SBP is in most cases an infection with a single organism, the presence of many organisms in the culture, raise the suspicion of secondary peritonitis [3]. Ascitic Fluid Infection (AFI) occurs in 10 to 30% of hospitalized cirrhotic patients. Despite the early start of treatment, which may lead to good results in most cases, the mortality still remains considerably high [4]. For this reason, early detection of inflammation is important for the assessment of AFI and for treatment options. Although the diagnosis is based mainly upon clinical suspicion, several methods have also been studied for early detection of AFI in cirrhotic patients [5]. Additional diagnostic tools, such as leucocyte esterase reagent strips, pH testing, and lactoferrin in ascitic fluid are also considered to be helpful in SBP diagnosis. Fecal calprotectin (FC), ascitic fluid calprotectin, proinflammatory cytokines like interleukin 1b [IL1b], tumor necrosis factor a (TNFa), and interleukin 6 (IL6) were also studied. Another study focused on the diagnostic role of plasma and ascitic fluid procalcitonin for estimating SBP diagnosis [6]. Circulating platelets are a plentiful source of prothrombotic agents which are inflammatory markers that have an important role in the inflammatory cascade [7]. e platelet content of granules increases as the platelet size increases to have their hemostatic and pro-inflammatory actions with more efficiency, for this reason mean platelet volume (MPV) is proposed to be an indicator of platelet function and activation. Some studies have reported that MPV increases in myocardial infarction, cerebrovascular disease, Alzheimer’s disease, hypertension, and celiac disease [8]. e current study was conducted to assess the potential role that MPV may have in the diagnosis of SBP in cirrhotic patients with ascites together with other inflammatory markers; ESR and CRP. Patients and Methods e current study is a case control study that took place during