From the Guidelines
Polymorphonuclear leukocytes (PMNs) are a crucial indicator of infection in ascitic fluid, and a count of 250 cells/mm3 or higher is a reliable threshold for initiating empiric antibiotic therapy in patients with suspected spontaneous bacterial peritonitis (SBP) 1. When considering the role of PMNs in gallbladder disease, it's essential to understand that the provided evidence primarily focuses on ascites and SBP in the context of cirrhosis. However, the principle of using PMN counts as an indicator of infection can be applied broadly. In the context of gallbladder disease, PMNs are key players in the inflammatory response, particularly in acute cholecystitis. The infiltration of PMNs into the gallbladder wall is a diagnostic marker of acute inflammation.
- The presence of PMNs in ascitic fluid is used to diagnose SBP, with a threshold of 250 cells/mm3 being indicative of infection 1.
- In gallbladder disease, the inflammatory process involves the infiltration of PMNs into the gallbladder tissue, which is a response to obstruction, chemical irritation, and potential bacterial infection.
- The density of PMNs in gallbladder tissue samples is an important diagnostic marker used by pathologists to confirm acute inflammation.
- Laboratory findings in acute gallbladder disease often show leukocytosis with neutrophilia, reflecting the systemic inflammatory response to the localized gallbladder inflammation.
- It's crucial to note that while the provided evidence does not directly address gallbladder disease, the principles of PMN response to infection can be applied across different conditions, emphasizing the importance of prompt diagnosis and treatment of infections based on clinical judgment and laboratory findings, such as PMN counts 1.
From the Research
Polymorphonuclear Leukocytes in Gallbladder Disease
- Polymorphonuclear leukocytes (PMNs) play a significant role in the defense response of the host during an episode of infection, including gallbladder disease 2.
- The functional activity of PMNs can be characterized by quantification and localization of respiratory burst production, which can be assessed by chemiluminescent (CL) byproduct reaction 2.
- A study used a luminol-amplified whole blood system to assess the functional states of PMNs in patients with acute infections, including gallbladder disease, and developed a classification model to distinguish between viral and bacterial infections with high predictive accuracy 2.
- However, the provided studies do not specifically investigate the role of polymorphonuclear leukocytes in gallbladder disease, but rather focus on the diagnosis, treatment, and management of gallbladder disease 3, 4, 5, 6.
- The studies provide information on the clinical presentation, pathophysiology, diagnostic evaluation, and management of various gallbladder disorders, including cholelithiasis, acute acalculous cholecystitis, and gallbladder cancer 3, 4, 5, 6.