Serum C-Reactive Protein in Children with Liver Disease and Ascites

Kalvandi, Gholamreza; Honar, Naser; Geramizadeh, Bita; Ataollahi, Maryam; Rahmani, Asghar; Javaherizadeh, Hazhir

doi:10.5812/hepatmon.56087

Cited by 2 publications

(5 citation statements)

References 31 publications

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“…Elevated ANC raises probability of infected ascites 9 times more. This was contradictory to other reports done by Preto-Zamperlini et al (2014) and Kalvandi et al (2016) [ 8 , 28 ]. Discrepancy between the results of TLC and ANC as markers of ascitic infection, in our study, could be explained by the fact that patients with CLD usually have splenomegaly and hypersplenism that can mask the TLC elevation in peripheral blood.…”

Section: Discussioncontrasting

confidence: 76%

“…In our study, TLC in the peripheral blood per se showed no statistically significant difference between infected and non-infected ascites patients. Although, other studies found that TLC was significantly higher in patients with AFI [ 8 , 28 ]. We also analyzed ANC as a predictor of AFI and we found that it is a significant independent factor associated with ascitic infection.…”

Section: Discussionmentioning

confidence: 88%

“…Other studies performed on pediatric patients with AFI reported similar results [ 21 , 26 ]. In contrast, Preto-Zamperlini et al (2014) reported that serum albumin levels were significantly higher in the non-infected group while Kalvandi et al (2016) found that serum albumin levels were significantly higher in the group with AFI [ 8 , 28 ]. The latter conclusion could be explained by that serum albumin level might be masked by previous albumin infusions in those patients.…”

Section: Discussionmentioning

confidence: 97%

“…CRP may be used as a marker for early detection and monitoring of SBP in children with liver disease with high sensitivity and specificity [ 8 , 28 ]. Yuan et al (2013) concluded that CRP is a better marker than TLC for diagnosis of patients with SBP [ 29 ].…”

Section: Discussionmentioning

confidence: 99%

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Routine analysis of ascitic fluid for evidence of infection in children with chronic liver disease: Is it mandatory?

Ghobrial¹,

Mogahed²,

El‐Karaksy³

2018

PLoS ONE

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Ascitic fluid infection is a major cause of morbidity and mortality in cirrhotic patients, requiring early diagnosis and therapy. We aimed to determine predictors of ascitic fluid infection in children with chronic liver disease. The study included 45 children with chronic liver disease and ascites who underwent 66 paracentesis procedures. Full history taking and clinical examination of all patients were obtained including fever, abdominal pain and tenderness and respiratory distress. Investigations included: complete blood count, C-reactive protein, full liver function tests, ascitic fluid biochemical analysis, cell count and culture. Our results showed that patients’ ages ranged between 3 months to 12 years. Prevalence of ascitic fluid infection was 33.3%. Gram-positive bacteria were identified in six cases, and Gram-negative bacteria in five. Fever and abdominal pain were significantly more associated with infected ascites (p value = 0.004, 0.006). Patients with ascitic fluid infection had statistically significant elevated absolute neutrophilic count and C-reactive protein. Logistic regression analysis showed that fever, abdominal pain, elevated absolute neutrophilic count and positive C-reactive protein are independent predictors of ascitic fluid infection. Fever, elevated absolute neutrophilic count and positive C-reactive protein raise the probability of ascitic fluid infection by 3.88, 9.15 and 4.48 times respectively. The cut-off value for C-reactive protein for ascitic fluid infection was 7.2 with sensitivity 73% and specificity of 71%. In conclusion, prevalence of ascitic fluid infection in pediatric patients with chronic liver disease and ascites was 33.3%. Fever, abdominal pain, positive C-reactive protein and elevated absolute neutrophilic count are strong predictors of ascitic fluid infection. Therefore an empirical course of first-line antibiotics should be immediately started with presence of any of these predictors after performing ascitic fluid tapping for culture and sensitivity. In absence of these infection parameters, routine ascitic fluid analysis could be spared.

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Section: Discussioncontrasting

confidence: 76%

Section: Discussionmentioning

confidence: 88%

Section: Discussionmentioning

confidence: 97%

Section: Discussionmentioning

confidence: 99%

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Routine analysis of ascitic fluid for evidence of infection in children with chronic liver disease: Is it mandatory?

Ghobrial¹,

Mogahed²,

El‐Karaksy³

2018

PLoS ONE

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“…Children and adolescents have a number of physiological, psychological, and social needs, one of which is their health (1)(2)(3). However, their health may be affected by diseases such as cancer (4), cardiovascular disease (5), thalassemia (6,7), liver disease (8), rickets (8), and orthopedic diseases (9). They may also be exposed to various diseases that threaten their lives, like other age groups (6,7,9).…”

Section: Contextmentioning

confidence: 99%

Laboratory and Radiologic Findings in Pediatrics with COVID-19: A Systematic Review

Shokri

Karimian

Mansouri

et al. 2020

Arch Clin Infect Dis

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Context: One of the emerging diseases that has spread in 2019 is COVID-19. Objectives: The present systematic review (SR) was performed to evaluate the status of laboratory and radiological findings in the age group of children and adolescents with COVID-19. Methods: In this SR study, three of the research team members conducted searches in SCOPUS, PUBMED, Science Direct, and ISI international sites. The keywords that were searched included children- pediatric- adolescents- coronavirus- COVID-19- Novel coronavirus SARS-CoV-2-epidemiology- diagnostic findings- laboratory findings- CT SCAN- computed tomography- percentage of lymphocyte- alanine aminotransferase- white blood cell count (WBC). The combination of search keywords with AND as well as OR was performed. For analysis, descriptive data reporting was performed using EndNote software. Results: The analysis of the laboratory and radiology findings of 197 patients of 12 studies included in the SR study showed notable changes in the lung CT scan and laboratory ranges that confirm the COVID-19 infection in these patients. Conclusions: This systematic review provides information on the laboratory and radiology findings of children and adolescents with COVID-19 for the health care team.

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Serum C-Reactive Protein in Children with Liver Disease and Ascites

Cited by 2 publications

References 31 publications

Routine analysis of ascitic fluid for evidence of infection in children with chronic liver disease: Is it mandatory?

Routine analysis of ascitic fluid for evidence of infection in children with chronic liver disease: Is it mandatory?

Laboratory and Radiologic Findings in Pediatrics with COVID-19: A Systematic Review

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