Role of serum-ascites albumin gradient in differential diagnosis of ascites
Journal Title: MedPulse -International Medical Journal - Year 2014, Vol 1, Issue 8
Abstract
Introduction: Ascites is mentioned even in the most ancient of medical texts, i.e. the papyrus Ebers of Ancient Egypt and the ayurveda of Hindu tradition (Jalodara), both dating from as early as 1500-1600 BC. The serum ascites albumin gradient has been proved in multiple studies to categorize ascites better than either the ascitic fluid total protein or other parameters in ascitic fluid analysis. Aims and objectives:To differentiate various causes of ascites on the basis of serum ascites albumin gradient and to determine the sensitivity and specificity of serum ascites albumin gradient in identifying the etiology of ascites. Material and Method: in the present study total 50 patients of ascites were enrolled. The serum ascites albumin gradient was calculated in all the patients after measuring the serum and ascitic fluid albumin concentrations and simply subtracting the ascitic fluid value from the serum value. To increase the accuracy of SAAG, specimens of serum and ascitic fluid were obtained simultaneously. Results: Cirrhosis of the liver (74%) was the most common cause of ascites in the study subjects. 8% cases of cirrhosis, 18% cases of TB ascites and 2% cases of peritoneal carcinomatosis had high SAAG ascites. 66% of Cirrhosis patients and one case of CCF, Nephrotic syndrome and Liver metastasis had low SAAG ascites. sensitivity, specificity, positive predictive value, negative predictive value and diagnostic accuracy of SAAG are 94.59%, 92.3%, 97.2%, 85.7% and 94% respectively. Conclusion: The accuracy of etiological diagnosis of ascites using SAAG was 94%.
Authors and Affiliations
S Suresh Saravanakumar, Buvana Balamugundan, Mervin K Soman
Keywords
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