Description

Gupta et al identified a number of biochemical results which can help to distinguish ascites due to cirrhosis from ascites due to malignancy or tuberculosis. The authors are from M.L.N. Medical College in Allahabad, India.


 

Patient selection: ascites in a developing country where cirrhosis, malignancy and tuberculosis comprise > 90% of cases of ascites

 

Parameters:

(1) serum total protein in g/dL

(2) serum albumin in g/dL

(3) ascites fluid total protein in g/dL

(4) ascites fluid albumin in g/dL

(5) ascites fluid cholesterol in mg/dL

 

ratio of ascites fluid to serum total protein =

= (ascites fluid total protein) / (serum total protein)

 

ratio of ascites fluid to serum albumin =

= (ascites fluid albumini) / (serum albumin)

 

serum to ascites fluid albumin gradient =

= (serum albumin) – (ascites fluid albumin)

 

Parameter

Cirrhosis-Associated Ascites

ascites fluid total protein

< 2.5 g/dL

ascites fluid albumin

< 2.0 g/dL

ascites fluid cholesterol

< 55 mg/dL

ascites fluid to serum total protein ratio

< 0.5

ascites fluid to serum albumin ratio

< 0.65

serum to ascites fluid albumin gradient

> 1.1

 


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