Therefore, an accurate and convenient method of rapid diagnosis selleck chemicals llc of SBP remains an unmet clinical need. Calprotectin, a calcium and zinc-binding protein, is detected almost exclusively in neutrophils[28], and its presence in body fluids is proportional to the influx of neutrophils[29-33]. However, only one study to date has investigated calprotectin levels in ascites and found higher concentrations in patients with malignant disease than in those with non-malignant disease[34]. In contrast, faecal calprotectin is a well-established marker of inflammation and is used to monitor inflammatory bowel disease[35]. A rapid bedside test has been developed to measure calprotectin in faeces; systematic comparison with the established enzyme-linked immunosorbent assay (ELISA) technique showed good correlation between the two tests�� results[36] and the rapid bedside test has been suggested as an equally valuable tool for diagnosing inflammatory bowel disease[37].

It is possible that such a rapid bedside test may be useful for measuring calprotectin in ascitic fluid to indicate PNM levels and SBP status, however the diagnostic accuracy of such a measurement in ascitic fluid is unknown. This study was designed to test our hypothesis that calprotectin in ascitic fluid could be useful as a surrogate PMN marker for identifying SBP patients (> 250/��L PNM). To this end, we measured calprotectin in ascites of consecutive patients referred for paracentesis using a rapid bedside test and compared the results to those from the traditional ELISA.

MATERIALS AND METHODS Setting and participants In this prospective observational study, we recruited patients with ascites referred for paracentesis to the Department of Gastroenterology and Hepatology at the University Hospital Basel, and to the Department of Gastroenterology, Hepatology and Clinical Nutrition at the Cantonal Hospital Liestal in Switzerland. All patients with ascites were eligible for study enrolment, irrespective of the aetiology of ascites. The decision to perform paracentesis was based on clinical findings evaluated by the referring physician who was otherwise not involved in the study. Exclusion Batimastat criteria were age < 18 years and recent abdominal surgery (< 3 mo). Standardised patient history, clinical symptoms, and demographic data were obtained from all participants. The study was carried out in accordance with the principles of the Declaration of Helsinki and with pre-approval from the local Ethic Committees of both study sites. All patients provided written informed consent prior to participation in any protocol-specific procedures. Endpoint The diagnostic value of ascitic calprotectin measurement was assessed in comparison to the adjudicated final diagnosis.