The Use of Platelet to Leukocyte Ratio as a Diagnostic Tool for Spontaneous Bacterial Peritonitis in Patients with HCV-Related Liver Cirrhosis

 Document Type: Original Clinical

Authors

Ahmed Elshafie   1, Mohamed Salaheldin 2, Heba Ismail Saad Aly 2, Michael George Sami Nada 1, Mohamed Hassan Ahmed Fouad  1, 3

1 Department of Internal Medicine, Gastroenterology and Hepatology Unit, Faculty of Medicine, Ain Shams University, Cairo, Egypt.

2 Department of Tropical Medicine, Faculty of Medicine, Ain Shams University, Cairo, Egypt.

3 Department of Internal Medicine, Armed Forces College of Medicine, Cairo, Egypt.

 10.21608/ajgh. 2026.451964.1094

Abstract

Background: Both leukocytes and platelets play important roles in response to infections. Spontaneous bacterial peritonitis (SBP) is a serious outcome of liver cirrhosis. Early diagnosis and treatment of SBP are essential for preventing further complications. A rapid, noninvasive tool for predicting SBP is needed.

Aim: To assess the platelet-to-leukocyte ratio as a noninvasive laboratory test for predicting SBP.

 Patient and methods This is a case-control study that was performed in the period between August 2023 and July 2024 at Ain Shams University Hospital, Cairo, Egypt. Thirty-six patients with cirrhotic ascites participated, of which 18 SBP patients were assigned to Group A, while the other 18 patients with cirrhotic ascites were assigned to Group B. Routine blood tests and ascitic fluid samples were evaluated for all patients.

 Results: The platelet/leukocyte ratio was significantly lower in SBP patients than in those with non-SBP cirrhotic ascites (median 6.47 [IQR 5.04] versus 15.8 [IQR 6.93]; p<0.001). The cut-off value for the platelet/leukocyte ratio to discriminate patients with SBP was 11.585, with 86.4% sensitivity and 87.8% specificity.

 Conclusion: The platelet/leukocyte ratio predicts SBP in patients with ascites due to liver cirrhosis.