الفهرس 
IntroductionOnly 14 pages are availabe for public view
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Abstract
Ascites is the pathological accumulation of free fluid in the peritoneal cavity. The fluid accumulates because of conditions directly involving the peritoneum (infection, malignancy), or due to other diseases remote from the peritoneum (i.e., liver disease, heart failure, hypoproteinaemia).
SBP is a frequent and severe complication in patients with cirrhosis and ascites. It is a bacterial infection that occurs in the absence of an evident intraabdominal and surgically treatable source of infection.
Some patients with SBP have symptoms or signs clearly suggestive of peritoneal infection where as others may be completely asymptomatic or with minor symptoms only. Therefore, diagnostic paracentesis is used commonly to investigate the prescence of SBP.
Lactoferrin is a red iron-binding whey protein present mainly in external secretions such as breast milk and in polymorphonuclear neutrophils. The presence of lactoferrin in body fluids is proportional to the flux of neutrophils and its assessment can provide a reliable biomarker for inflammation.
In gastrointestinal diseases increased fecal lactoferrin is a sensitive and specific surrogate marker for inflammatory bowel diseases in patients with chronic diarrhea and pain, and ascites lactoferrin can also provide a promising and reliable biomarker for bacterial peritonitis.
The measurement of ascitic fluid lactoferrin could provide a reliable biomarker for the presence of PMNs and detection of SBP in patients with cirrhosis as lysis of the PMNs during transport to the laboratory may lead to false negative results.
The rationale of our study was to review and assess our knowledge about the value of ascitic fluid lactoferrin level as a diagnostic tool to identify SBP in patients with ascites caused by cirrhosis.
Our study included 6 original articles, 2 responses and editorials to the first published original article, 2 review articles, one conference abstract and one systematic review.
All of the 6 original articles in cluded in this systematic review showed that ascetic fluid lactoferrin level is much higher among patients with SBP compared to those without SBP.
Conclusion
The measurement of ascitic fluid lactoferrin could provide a reliable biomarker for the presence of PMNs and detection of SBP in patient with cirrhosis. ascetic fluid lactoferrin level is much higher among patients with SBP compared to those without SBP.