MCP1, CRP and Procalcitonin as Novel Diagnostic Markers in Cirrhotic Patients with Spontaneous Bacterial Peritonitis

Amal Ahmed Mohamed1, Wafaa Salah2, Mohamed Badr Hassan3, Hala H. Eldeeb4, Ahmed Sobhy Adaroas4, Rania Abdelmonem Khattab5, Heba M. Abostate6, Moataz Yousry Soliman7, Eslam Habba8, Sherief Abd-Elsalam8, *, Yousry Esam-Eldin Abo-Amer7
1 Department of Biochemistry Molecular Biology, National Hepatology and Tropical Medicine Research institute, Cairo, Egypt
2 Internal Medicine Department, National Institute of Diabetes and Endocrinology, Cairo, Egypt
3 Internal Medicine Department, Faculty of Medicine, Cairo University, Cairo, Egypt
4 Department of Clinical and Chemical Pathology, El Sahel Teaching Hospital, Cairo, Egypt
5 Department of Microbiology and Immunology, Faculty of Pharmacy, Cairo University, Cairo, Egypt
6 Microbiology, Faculty of Pharmacy, Egyptian Russian University, Cairo, Egypt
7 Hepatology, Gastroenterology and Infectious Diseases Department, Mahala Hepatology Teaching Hospital, Tanta, Egypt
8 Department of Tropical Medicine, Faculty of Medicine, Tanta University, Tanta, Egypt

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© 2022 Mohamed et al.

open-access license: This is an open access article distributed under the terms of the Creative Commons Attribution 4.0 International Public License (CC-BY 4.0), a copy of which is available at: This license permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

* Address correspondence to this author at the Department of Tropical Medicine, Faculty of Medicine, Tanta University, Postal code: 35111. Address: Elbahr Street, Tanta, Egypt; Tel: 00201063319696; E-mail:


Background & Aims:

The aim of the study was to evaluate serum c-reactive protein (CRP), ascitic procalcitonin (PCT) and monocyte chemotactic protein-1 (MCP-1) in the diagnosis of spontaneous bacterial peritonitis (SBP) in cirrhotic patients.


A cross-sectional analytic study that included 199 patients with decompensated cirrhosis (101 with SBP and 98 without SBP). Patients were classified according to Child-Pugh criteria. Ascitic PCT and MCP-1 were measured by enzyme-linked immunosorbent assay. Serum CRP, liver and renal functions were assessed.


Three markers are significantly elevated in SBP patients than those without ascites. Using the ROC curve at AUC 0.883 and a cut-off value of >186 ng/ml, the diagnostic performance of ascitic MCP-1 level was higher than CRP (AUC 0.562) and ascitic fluid procalcitonin (AUC 0.751) in the diagnosis of SBP. The sensitivity and specificity were 86.15% and 79.59% at the cutoff of 186 ng/ml for MCP-1, 65.4 and 75.5 at ≥ 1 ng/ml for PCT, and 52.5 and 64.3, respectively for at 11.2 mg/dl CRP.


Ascitic MCP-1 has a better diagnostic value with higher sensitivity and specificity in diagnosis SBP compared to CRP and procalcitonin which has higher diagnostic accuracy than CRP. Further studies with a large number will be necessary to evaluate the usefulness of these markers in diagnosis, follow-up and relation to morbidity and mortality of SBP patients.

Keywords: Cirrhosis, Ascites, Liver cell Failure, SBP, CRP, Procalcitonin, Monocyte Chemotactic Protein-1(MCP-1).