Fecal Calprotectin in Patients with Hepatic Encephalopathy

Abstract

Background and study aim: Cal-protectin is a cytoplasmatic protein of neutrophilic granulocytes and it is an established marker for the assessment of localized intestinal inflammation .Bacterial translocation is known to play an important role in the pathogenesis of certain complications of cirrhosis such as hepatic encephalopathy (HE). This study amid to assess: the value of fecal calprotectin in the diagnosis of hepatic encephalopathy, relationship between level of fecal calprotectin and the degree of hepatic encephalopathy. Patients and Methods: This cross sectional study was conducted on 90 patients attended to the Hepatology, Gastroenterology and Infectious Diseases Department of Benha University Hospital between March and July 2016. All medical diseases which are known to influence the level of fecal calprotectin were excluded (as: gastro-intestinal bleeding or inflmmatory bowel disease). The degree of liver insufficiency was assessed according to the Child Pugh classifiation and Model of End Stage Liver Disease (MELD); and degree of hepatic encephalopathy by West-Haven criteria, and the number connection test. Results: The mean value of fecal calprotectin in patients with overt HE was 304.4 ± 41.05 μg/g, and in patients with MHE was 74.4 ± 23.9 μg/g and in the group of liver cirrhosis without encephalopathy was 57.55± 8.92 and in healthy group was 25.22 ± 8.63, respectively with high significant difference (p<0.001). There was no significant correlation between fecal calprotectin and (age, psychometric test, Child-Pugh classification, MELD score and West-Haven criteria). Conclusion: This study confirmed significantly higher values of fecal calprotectin in patients with hepatic encephalopathy. Among patints with OHE and patients of MHE, no significant correlation between fecal calprotectin and age, psychometric test, Child classification, MELD score and West-Haven criteria were detected.