scholarly journals The value of adenosine deaminase (ADA) determination in the diagnosis of tuberculous ascites

1995 ◽  
Vol 37 (5) ◽  
pp. 449-453 ◽  
Author(s):  
Cesar Q. Brant ◽  
Mario R. Silva Jr. ◽  
Erica P. Macedo ◽  
Claudio Vasconcelos ◽  
Natalina Tamaki ◽  
...  
Keyword(s):  
Adenosine Deaminase ◽  
Ascitic Fluid ◽  
Spontaneous Bacterial Peritonitis ◽  
Malignant Ascites ◽  
Bacterial Peritonitis ◽  
Pancreatic Ascites ◽  
Adenosine Deaminase Activity ◽  
Sensitivity Specificity

In order to evaluate the role of the determination of adenosine deaminase activity (ADA) in ascitic fluid for the diagnosis of tuberculosis, 44 patients were studied. Based on biochemical, cytological, histopathological and microbiological tests, the patients were divided into 5 groups: G1 - tuberculous ascites (n = 8); G2 - malignant ascites (n = 13); G3 - spontaneous bacterial peritonitis (n = 6); G4 - pancreatic ascites (n = 2); G5 - miscelaneous ascites (n = 15). ADA concentration were significantly higher in G1 (133.50 ± 24.74 U/l) compared to the other groups (G2 = 41.85 ± 52.07 U/l; G3 = 10.63 ± 5.87 U/l; G4 = 18.00 ± 7.07 U/l; G5 = 11.23 ± 7.66 U/l). At a cut-off value of >31 U/l, the sensitivity, specificity and positive and negative preditive values were 100%, 92%, 72% and 100%, respectively. ADA concentrations as high as in tuberculous ascites were only found in two malignant ascites caused by lymphoma. We conclude that ADA determination in ascitic fluid is a useful and reliable screening test for diagnosing tuberculous ascites. Values of ADA higher than 31 U/l indicate more invasive methods to confirm the diagnosis of tuberculosis.

Study of the role of ascitic fluid lactoferrin levels in the diagnosis of spontaneous bacterial peritonitis

2016 ◽  
Vol 29 (2) ◽  
pp. 464
Author(s):  
Ahmed Elmaaz ◽  
Atef Abulseoud ◽  
Hossam Ibrahim ◽  
Abdallah Essa ◽  
Enas Essa
Keyword(s):  
Ascitic Fluid ◽  
Spontaneous Bacterial Peritonitis ◽  
Bacterial Peritonitis

scholarly journals The Role of Ascitic Fluid Viscosity in the Differential Diagnosis of Ascites

2010 ◽  
Vol 24 (4) ◽  
pp. 255-259 ◽  
Author(s):  
Huseyin Savas Gokturk ◽  
Mehmet Demir ◽  
Nevin Akcaer Ozturk ◽  
Gulhan Kanat Unler ◽  
Sevsen Kulaksizoglu ◽  
...  
Keyword(s):  
Portal Hypertension ◽  
Ascitic Fluid ◽  
Total Protein ◽  
Small Sample ◽  
Fluid Viscosity ◽  
Serum Total Protein ◽  
Bacterial Peritonitis ◽  
The Mean ◽  
Sensitivity Specificity

BACKGROUND: Ascites is defined as the pathological accumulation of fluid in the peritoneal cavity. It is the most common complication of cirrhosis, which is also the most common cause of ascites. Viscosity is a measure of the resistance of a fluid to deform under shear stress. Plasma viscosity is influenced by the concentration of plasma proteins and lipoproteins, with the major contribution from fibrinogen. To our knowledge, the viscosity of ascitic fluid has not yet been studied.OBJECTIVE: To evaluate the role of ascitic fluid viscosity in discriminating between ascites due to portal hypertension-related and nonportal hypertension-related causes, and to compare results with the serum-ascites albumin gradient (SAAG).METHODS: The present study involved 142 patients with ascites presenting with diverse medical problems. Serum total protein, albumin, glucose, lactate dehydrogenase (LDH) levels and complete blood count were obtained for all subjects. Paracentesis was performed routinely on admission and all ascitic fluid samples were evaluated by manual cell count with differential, ascitic fluid culture and biochemistry (total protein, albumin, glucose and LDH). Cultures of ascitic fluid were performed at bedside in all patients using blood culture bottles. Ascitic fluid viscosity was measured in a commercially available cone and plate viscometer.RESULTS: Of the 142 patients studied, 34 (24%) had an SAAG of 11 g/L or less, whereas 108 (76%) had an SAAG of greater than 11 g/L. Sex and mean age did not differ significantly between the two groups (P>0.05). Serum total protein, albumin, glucose, LDH levels, leukocyte count, ascitic fluid glucose levels and ascitic fluid leukocyte counts were similar in both groups, with no statistically significant relationship detected (P>0.05). However, the mean (±SD) ascitic fluid total protein (0.0172±0.1104 g/L versus 0.043±0.011 g/L), albumin (0.0104±0.0064 g/L versus 0.0276±0.0069 g/L) and LDH (102.76±80.95 U/L versus 885.71±199.93 U/L) were found to be higher in patients with an SAAG of 11 g/L or less than in those with an SAAG of greater than 11 g/L (P<0.001). The mean ascitic fluid viscosities were 0.86±0.12 centipoise (cP) and 1.22±0.25 cP in patients with an SAAG greater than 11 g/L and an SAAG of 11 g/L or less, respectively (P<0.001). Although ascitic fluid infection was detected in 35 patients (24.6%) (19 patients with spontaneous bacterial peritonitis, seven patients with culture-negative neutrocytic ascites, three patients with monobacterial non-neutrocytic bacterascites and six patients with secondary bacterial peritonitis), no significant effect on ascitic fluid viscosity was detected. Multiple linear regression analysis revealed that ascitic fluid total protein, albumin and LDH levels were independent predictors of ascitic fluid viscosity (P<0.001). The sensitivity, specificity, and positive and negative predictive values of ascitic fluid viscosity for the discrimination between ascites due to portal hypertension-related and nonportal hypertension-related causes according to the SAAG were determined by receiver operating characteristic analysis. Regarding the cut-off value of 1.03 cP, ascitic fluid viscosity measurement had a high sensitivity, specificity (98% and 80%, respectively), and positive and negative predictive value (79% and 94%, respectively) for the etiological discrimination of ascites.CONCLUSION: The measurement of ascitic fluid viscosity correlates significantly with SAAG values. In view of its simplicity, low cost, small sample volume requirement and allowance for measurement in previously frozen samples, measurement of ascites viscosity could be useful for the accurate and rapid classification of ascites.

scholarly journals Role of ascitic fluid C3 in spontaneous bacterial peritonitis

2012 ◽  
Vol 13 (1) ◽  
pp. 81-85 ◽  
Author(s):  
Amany Talaat Kamal ◽  
Eman Nagib Osman ◽  
Rasha Youssef Shahin
Keyword(s):  
Ascitic Fluid ◽  
Spontaneous Bacterial Peritonitis ◽  
Bacterial Peritonitis

scholarly journals Spontaneous Bacterial Peritonitis Caused byListeria monocytogenesAssociated with Ascitic Fluid Lymphocytosis: A Case Report and Review of Current Empiric Therapy

2013 ◽  
Vol 2013 ◽  
pp. 1-3
Author(s):  
Todd Yecies ◽  
Sanae Inagami
Keyword(s):  
Ascitic Fluid ◽  
Spontaneous Bacterial Peritonitis ◽  
Alcoholic Cirrhosis ◽  
Malignant Ascites ◽  
Empiric Therapy ◽  
First Line ◽  
Bacterial Peritonitis ◽  
First Line Therapy ◽  
Line Therapy ◽  
Unusual Finding

Spontaneous bacterial peritonitis (SBP) is a potentially deadly complication of ascites. We describe a case of SBP caused byListeria monocytogenesin a patient with alcoholic cirrhosis. This was associated with the unusual finding of ascitic fluid lymphocytosis, which previously had only been associated with tuberculoid or malignant ascites. Given increasing rates of cefotaxime-resistant SBP alongside the possibility of Listeriosis, the use of cefotaxime as first-line therapy in SBP should be reevaluated.

scholarly journals Role of ascitic fluid study in early detection of spontaneous bacterial peritonitis in asymptomatic patients of cirrhosis of liver

2019 ◽  
Vol 30 (1) ◽  
pp. 9-18
Author(s):  
Md Asadul Kabir ◽  
Md Maniruzzaman Sarkar ◽  
Kazi Bodruddoza ◽  
Anwarul Bari ◽  
Jewel Chowdhury
Keyword(s):  
Liver Disease ◽  
Early Detection ◽  
Ascitic Fluid ◽  
Spontaneous Bacterial Peritonitis ◽  
Abdominal Tenderness ◽  
Bacterial Peritonitis ◽  
Fluid Analysis ◽  
Cell Counts ◽  
Asymptomatic Patients

Spontaneous bacterial peritonitis (SBP)is an acute bacterial infection of ascitic fluid and one of the commonest complication of patients with cirrhosis presented with ascitis. Routine analysis of ascetic fluid particularly for polymorphonuclear leukocyte is an important tool for detecting spontaneous bacterial peritonitis including clinically unsuspected and asymptomatic patients also. Thus it helps in reducing mortality and morbidity by early and effective detection of spontaneous bacterial peritonitis. Objective: This study was carried out to evaluate the role of ascitic fluid analysis in early detection of spontaneous bacterial peritonitis and to document the proportion of spontaneous bacterial peritonitis present asymptomatically. Study design: This was a cross sectional observational study prospective in nature on 50 cases of diagnosed chronic liver disease patients in indoor of department of medicine of Sir Salimullah medical college Hospital, Dhaka from 02/01/13 to 01/07/13, for a period of 6 months. Result: The study showed that age frequency 5(10%) were from 21-30 years, 15(30%) were from 31- 40 years, 15(30%) were from 40 -50years and 15(30%) were from >50 years of age. Out of 50 patients, 38(76%) were male and 12(24%) were female patients. The etiology of liver cirrhosis was hepatitis B virus in 22(44%), hepatitis C virus in 4(8%), alcohol in 1 (2%) and others in 23(46%) patients. Among 50 patients, 16(32%) were spontaneous bacterial peritonitis and 34(68%) were non spontaneous bacterial peritonitis. The symptoms of spontaneous bacterial peritonitis were upper GI bleeding in 8 patients (50%), fever in 12 patients (75%), abdominal pain in 10 patients (62.5%), abdominal tenderness in 7 patients (43.75%), hepatic encephalopathy in 9 patients (56.25%), jaundice in 10 patients (62.50%), splenomegaly in 16 patients (100%), ascites in 16 patients (100%) and 5 (10%) patients were asymptomatic spontaneous bacterial peritonitis. According to Child Pugh’s, 2(12.5%) patients were at stage-A, 5 (31.25%) patients were at stage-B and 9 (56.25%) patients were at stage- C. Ascitic fluid characteristics (mean +SD) of all patients were, Total cell counts/mm3 (571+499.9), Neutrophil counts/mm3 (144.8+445.1), Sugar (112+38.19) mg/dl, Protein (1.85+1.09). Among SBP patients, 7 (43.75%) have PMN cell counts 250-750/mm3, 6 (37.50%) have 750-1750/mm3 and 3 (18.75%) have >1750/mm3. Conclusion: Spontaneous bacterial peritonitis is a common complication of decompensated cirrhotic patients. The classical signs of SBP (e.g. abdominal tenderness or fever) may not be present. We observed the trend towards more frequent occurrence of the infection in patients suffered from severe liver disease (e.g. Child Pugh’s –C) and the role of ascitic fluid analysis is statically significant. Bangladesh J Medicine Jan 2019; 30(1) : 9-18

Critical analysis of Jalodara (Ascites) - A Review.

2017 ◽  
Vol 2 (1) ◽  
Author(s):  
Manjunath Kotihal ◽  
Totad Muttappa ◽  
Vasantha B ◽  
Sandrima K. S.
Keyword(s):  
Developing Countries ◽  
Liver Cirrhosis ◽  
Cause Of Death ◽  
Ascitic Fluid ◽  
Peritoneal Cavity ◽  
Critical Analysis ◽  
Spontaneous Bacterial Peritonitis ◽  
Bacterial Peritonitis ◽  
Secondary Diseases

Ascites is a gastroenterological term for an accumulation of fluid in the peritoneal cavity that exceeds 25ml. Ascitic fluid can accumulate as a transudate or an exudate, this is secondary diseases to such as portal hypertention, spontaneous bacterial peritonitis and liver cirrhosis. Hence it is considered as one of the leading cause of death in the developing countries. Here Ascites has been understood as Jalodara. Udara is manifested because of Rasa Dhatu portion which gets extravesated from Kosta, Grahanyadi gets collected in Udara being influenced by Prakupita Vata the disease is called as Jalodara. For Dosha Nirharana Nitya Virechana, and other oral Ayurvedic medications are used as a mode of treatment. This paper throws an insight to the understanding and management of Ascites under the heading of Jalodara and also highlights the role of Nitya Virechana in the management of Jalodara.

scholarly journals SPONTANEOUS BACTERIAL PERITONITIS

2018 ◽  
Vol 25 (04) ◽  
pp. 589-593
Author(s):  
Umme Aeman Khan ◽  
Hamna Iqbal ◽  
Muhammad Omer Aslam ◽  
Muhammad Ehtisham Saqib ◽  
Hafiz M. Yassen ◽  
...  
Keyword(s):  
Diagnostic Accuracy ◽  
Ascitic Fluid ◽  
Neutrophil Count ◽  
Gold Standard ◽  
Spontaneous Bacterial Peritonitis ◽  
Positive Likelihood Ratio ◽  
Bacterial Peritonitis ◽  
Wbc Count ◽  
Sensitivity Specificity ◽  
Study Setting

Objectives: To find out the diagnostic accuracy of ascitic fluid LactateDehydrogenase in diagnosis of Spontaneous bacterial peritonitis using ascitic fluid absoluteneutrophil count equal to or greater than 250 cells/mm3 as a Gold Standard. Study Design:Cross sectional (validation) study. Setting: This study was conducted in department ofMedicine, Madina Teaching Hospital Faisalabad. Duration of Study: 6 months starting afterapproval of synopsis (From:01-06-2016 to 30-11-16). Methodology: 10 ml of ascitic fluidwas withdrawn from these patients, and sent for cytology and biochemistry. Ascitic fluid cellcount, total protein, albumin and LDH wascalculated along with serum albumin and serumLDH. Serum LDH and ascitic fluid LDH was calculated by using Cobas C311 Roche Analyzer,serum/ascitic albumin gradient (SAAG) was calculated by subtracting ascitic albumin fromserum albumin to prove portal hypertension as a cause of ascites. AsciticLDH/serum LDH ratiowas calculated by dividing ascitic LDH by serum LDH.Absolute neutrophil count was derivedfrom total WBC count. Results: In our study, mean age was calculated as 45.37+11.13 years,53.75% (n=43) were male and 46.25% (n=37) were females. Frequency SBP on gold standardwas recorded in 52.5% (n=42). Diagnostic accuracy of ascitic fluid lactate dehydrogenasein diagnosis of spontaneous bacterial peritonitis using ascitic fluid absolute neutrophil countequal to or greater than 250 cells/mm3 as a gold standard was recorded as 82.22%, 85.71%,88.09%, 78.95%, 83.75% for sensitivity, specificity, positive predictive value, negative predictivevalue and accuracy rate, positive likelihood ratio was calculated as 5.75 and 0.21 for negativelikelihood ratio was calculated as 5.75. Conclusion: The diagnostic accuracy of ascitic fluidLactate Dehydrogenase is higher in diagnosis of Spontaneous bacterial peritonitis using asciticfluid absolute neutrophil count equal to or greater than 250 cells/mm3 as a Gold Standard.

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