الفهرس 
Title : Serum and ascitic fluid 25-hydroxy vitamin d gradient as a potential diagnostic biomarker of spontaneous bacterial peritonitis in patients with cirrhotic ascites
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Abstract
Introduction: Spontaneous bacterial peritonitis (SBP) is considered the paradigmatic model of infection in patients with liver cirrhosis. It is often associated with high mortality particularly with the delay in its diagnosis. There is a need for an accurate and a rapid method for SBP diagnosis. Aim: This study aimed at evaluating the role of serum and ascitic fluid 25-OH vitamin D gradient as a potential diagnostic biomarker for spontaneous bacterial peritonitis in patients with cirrhotic ascites. Methods: This is a cross-sectional analytic study including 88 patients with liver cirrhosis and portal hypertensive ascites who underwentparacentesis at the Department ofEndemic Medicine, Faculty of Medicine,Cairo University. Patients were divided into 2 groups depending on whether SBP was present or not: group I: comprised 44 patients with SBP (a polymorphonuclear leukocyte (PMN) count in ascitic fluid exceeding 250 cells/mm3).group II: comprised 44 patients without SBP. A blood sample for serum 25-OH vitamin D measurementwas taken on the day the patient underwent ascitic fluid paracentesis. The level of 25-OH vitamin D in serum and ascitic fluid was measured using high performance liquid chromatography autoanalyzer (HPLC).The serum ascites25-OH vitamin D gradient (SADG) was calculated with theformula:25-OH vitamin D in serum{u2014} 25-OH vitamin D in ascites.Complete blood count, liver and kidney functions, pelvi-abdominal ultrasound and ascitic fluid study were performed. The demographic, clinical andlaboratory characteristics of the patients were recorded. Results: Patients with SBP showed a significantly lower SADG (p = 0.004) and hemoglobin (Hb) (p = 0.03) and a significantly higher serum urea level compared with patients without SBP(p = 0.02). Vitamin D deficiency was detected in the majority of the studied patients regardless of SBP diagnosis