TY - JOUR
T1 - Clinical usage of serum albumin to ascitic fluid albumin gradient and ascitic fluid total protein in pediatric ascites
AU - Karnsakul, Wikrom
AU - Wasuwanich, Paul
AU - Ingviya, Thammasin
AU - Laengvejkal, Pavis
AU - Vasilescu, Alexandra
AU - Imteyaz, Hejab
AU - Scheimann, Ann O.
N1 - Publisher Copyright:
© 2020 Elsevier Masson SAS
PY - 2021/5
Y1 - 2021/5
N2 - Background: Abdominal paracentesis is performed as a diagnostic test in children with ascites. Serum albumin to ascitic fluid albumin gradient (SAAG) is frequently used in adults to distinguish types of portal hypertension. We aim to investigate the utilization of SAAG and other biomarkers in determining the etiology of significant ascites in children. Methods: In this retrospective study, children aged 0–21 years with significant ascites were identified using International Classification of Diseases, Ninth Revision (ICD-9) codes and medical records during the period 1983–2010. Medical records of children who had abdominal paracentesis were examined in detail. Results: 207 children had significant ascites and of those children, 20 (9.6%) had abdominal paracentesis. Our data showed that high albumin gradient (SAAG ≥ 1.1 g/dL) differentiates causes of ascites secondary to portal hypertension (cirrhosis, hepatic vein outflow obstruction, or congestive hepatopathy) from other causes. In addition, ascitic fluid total protein (AFTP) may help in differential diagnosis of ascites. Children with high SAAG manifest clinical features of portal hypertension including esophageal varices or variceal hemorrhage. Conclusion: Among patients with initially unclear causes of ascites, SAAG and AFTP can provide guidance for appropriate investigations.
AB - Background: Abdominal paracentesis is performed as a diagnostic test in children with ascites. Serum albumin to ascitic fluid albumin gradient (SAAG) is frequently used in adults to distinguish types of portal hypertension. We aim to investigate the utilization of SAAG and other biomarkers in determining the etiology of significant ascites in children. Methods: In this retrospective study, children aged 0–21 years with significant ascites were identified using International Classification of Diseases, Ninth Revision (ICD-9) codes and medical records during the period 1983–2010. Medical records of children who had abdominal paracentesis were examined in detail. Results: 207 children had significant ascites and of those children, 20 (9.6%) had abdominal paracentesis. Our data showed that high albumin gradient (SAAG ≥ 1.1 g/dL) differentiates causes of ascites secondary to portal hypertension (cirrhosis, hepatic vein outflow obstruction, or congestive hepatopathy) from other causes. In addition, ascitic fluid total protein (AFTP) may help in differential diagnosis of ascites. Children with high SAAG manifest clinical features of portal hypertension including esophageal varices or variceal hemorrhage. Conclusion: Among patients with initially unclear causes of ascites, SAAG and AFTP can provide guidance for appropriate investigations.
KW - Exudates and transudates
KW - Liver cirrhosis
KW - Paracentesis
KW - Portal hypertension
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U2 - 10.1016/j.clinre.2020.09.010
DO - 10.1016/j.clinre.2020.09.010
M3 - Article
C2 - 33268292
AN - SCOPUS:85093943377
SN - 2210-7401
VL - 45
JO - Clinics and Research in Hepatology and Gastroenterology
JF - Clinics and Research in Hepatology and Gastroenterology
IS - 3
M1 - 101549
ER -