Diagnostic utility of serumascites lipid and protein gradients in differentiation of ascites

Prabhu, Mukhyaprana M and Gangula, Rahul Sai and Stanley, Weena (2019) Diagnostic utility of serumascites lipid and protein gradients in differentiation of ascites. International Journal of Hepatology, 2019. pp. 1-11. ISSN 2090-3448

[img] PDF
RMS - 00006709.pdf - Published Version
Restricted to Registered users only

Download (1MB) | Request a copy

Abstract

Context. Ability of SAAG to differentiate malignant ascites from other aetiologies like tubercular peritonitis is a major problem. Alternate screening test is needed for differentiating ascites due to malignancy from those due to tubercular peritonitis. Aims. To study the diagnostic utility of serum ascites lipid gradients and serumascites protein gradients in pathophysiological differentiation of ascites. Settings and Design. The present study is a prospective, descriptive, hospital-based, cross-sectional study. Methods and Material:The studywas conducted on patientswith asciteswhowere admitted to General Medicine Department, Kasturba Hospital, Manipal. The study included 60 patients with ascites of different etiologies (liver cirrhosis, tubercular peritonitis, and malignant ascites). All of them had undergone clinical, laboratory, and imaging investigations and were treated as per standard of care. All patients underwent abdominal paracentesis, and fluid samples were sent for analysis. Statistical Analysis Used. ANOVA,Kruskal- Wallis H test, and ROC curve analysis. Results. Among the gradients, only SAPG and SAAG had over all statistical significance (<0.005) among the groups, but no significance between malignancy and tubercular peritonitis had been observed. Similarly all the ascitic fluid parameters measured had an overall statistical significance (<0.005), but there was no significant difference observed betweenmalignancy and tubercular peritonitis groups. However, ascitic fluid and serumHDL cholesterol had a statistical significance (<0.05) between malignancy and tubercular peritonitis. Conclusions. With a cut-off value of 4, SAPG is one of best screening tests in differentiation of cirrhotic with noncirrhotic ascites when compared with SAAG, whereas it is a poor parameter with high sensitivity and very low specificity in differentiation of malignant with nonmalignant ascites. Also the present study reveals HDL cholesterol levels in ascitic fluid to be a valuable marker with higher sensitivity and specificity in differentiation of malignancy and tuberculosis peritonitis (i.e., differentiation of low SAAG ascites).

Item Type: Article
Subjects: Medicine > KMC Manipal > Medicine
Depositing User: KMC Library
Date Deposited: 08 Jun 2019 05:49
Last Modified: 08 Jun 2019 05:49
URI: http://eprints.manipal.edu/id/eprint/153937

Actions (login required)

View Item View Item