The Relevance of Ascitic Lactate Dehydrogenase (LDH) and Serum Ascites Albumin Gradient (SAAG) in the Differential Diagnosis of Ascites among Patients in a Nigerian Hospital
Journal Title: Journal of Advances in Medicine and Medical Research - Year 2015, Vol 8, Issue 3
Abstract
Aim: The study aimed to determine the diagnostic values for lactate dehydrogenase (LDH) and serum ascites albumin gradient (SAAG) with maximum sensitivity and minimum false positivity so as to differentiate malignancy-related ascites from non-malignant ascites in South West region of Nigeria. Study Design: This is a cross sectional study to determine the correlation between ascitic fluid LDH and SAAG and malignant and non-malignant ascites. Place and Duration of Study: This study was carried out at the clinics of gastroenterology, surgery, and obstetrics/gynecology at the Lagos University Teaching Hospital (LUTH), between August 2011 and July 2013. Methods: A total of 75 patients with ascites admitted into Lagos University Teaching Hospital (LUTH) from 2011 to 2013 were enrolled for the study. Thirty seven (7males, 30 females) had malignancy-related ascites while 38(18 males, 20 females) had non-malignant ascites. Levels of LDH and SAAG were determined in all patients with ascites. Statistical analysis was performed using SPSS software application (version 15.0) and p˂0.05 was considered statistically significant and results expressed as mean ± standard deviation. Results: A total of 75 patients were recruited for the study. Twenty-five of them (33.3%) were males while 50(66.7%) were females. The mean age for both sexes was 59.03±13.54 years. Using Receiver Operator Characteristic (ROC) curve, cut-off levels were 11.5 for SAAG and 310 IU/l for LDH. These cut-offs divided the malignant from the non-malignant group. Higher levels of ascitic LDH were seen in the malignant group (900.67±918.45 IU/l) when compared to the non-malignant group (199.29±194.53 IU/l). This was statistically significant (P<0.05). The diagnostic accuracy of LDH was 90.7%. SAAG was lower in the malignant (6.74±4.84 g/L) group when compared to the non-malignant (13.56±7.50 g/L). This was also statistically significant (P<0.05). The diagnostic accuracy of SAAG was 73.3%. Conclusion: It was concluded that measurement of ascitic fluid LDH and SAAG were relevant in differentiating malignant from non-malignant ascites. The determined cut-off values for LDH and SAAG in this study provides the distinctive differential diagnosis between malignant and non-malignant ascites. Routine analysis of serum and ascitic fluid albumin and LDH will resolve the problem of malignant and non-malignant ascites especially in low-resource areas or in the developing world.
Authors and Affiliations
E. E. L. Ekpe, A. J. Omotoso
Keywords
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- EP ID EP347389
- DOI 10.9734/BJMMR/2015/12554
- Views 45
- Downloads 0
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