The role of mean platelet volume in the diagnosis of spontaneous bacterial peritonitis

Background and study aim: Spontaneous bacterial peritonitis is a serious condition that needs rapid diagnosis and rapid management due to its serious sequelae. SBP is diagnosed when the polymorpho-nuclear cells count in the ascetic fluid exceeds 250 cell/µL. Mean platelet volume (MPV) was found to be significantly larger in the cirrhotic patients with ascetic fluid infection than cirrhotic patients without ascetic fluid infection. In our study we aimed to assess the role and clinical performance of MPV as a diagnostic marker of SBP. Patients and Methods: This cross sectional study was performed on 124 cirrhotic patients with ascites. They were classified into two groups according to ascetic fluid PMN count into two groups. Group I: 38 patients with ascetic fluid infection, PMN >250 cell/µL and group II: 86 patients without ascetic fluid infection, PMN count Results: The MPV was significantly higher among patients with ascetic fluid infection (11.1±1.2 vs 9.4±1.1 p<0.001). Blotting the ROC curve, MPV was proved to diagnose SBP at a cut off value of 10.45 fL with sensitivity and specificity of 74.4% and 78.9% respectively. Conclusion: MPV is a useful diagnostic marker that can predict the presence of SBP in cirrhotic patients with ascites

Osteoporosis in Chronic Hepatitis C

Background and study aim: Hepatitis C virus infection is a multisystemic disease with many extrahepatic manifestations. Affection of bone matrix density is a common complication of chronic hepatitis and cirrhosis. The pathogenesis of osteoporosis in chronic liver disease is still unknown and is expected to be multifactorial. The aim of this work is to assess the frequency of osteoporosis/osteopenia in patients with chronic hepatitis C virus infection with or without cirrhosis.Patients and methods:This study was carried out on 30 patients with chronic HCV infection without cirrhosis (Group II); 30 patients with chronic HCV infection with compensated cirrhosis (Group III) and 20 age and gender matched healthy controls (Group I). All subjects of the study performed liver function tests; viral markers; liver biopsy; hormonal assay and Bone Mineral density measurement (BMD) by Dual energy X-ray absorptiometry (DEXA).Results : In patients with chronic hepatitis C (group II) the frequency of osteopenia was 11 (36.7); osteoporosis 2 (6.7); total patients with low BMD was 13 (43.3). In cirrhotic patients (group III); the frequency of osteopenia was 13 (43.3); osteoporosis was 3 (10.0); and total patients with low BMD was 16(53.3) vs 1(5.0) in the control group (group I). there was also no significant difference between patients with low BMD and patients with normal BMD as regards age; gender; common risk factors; liver function tests or hormonal levels.Conclusion : Reduced BMD is common chronic HCV-infected patients with and without cirrhosis. HCV infection is a risk factor of osteoporosis