Complement and Immunoglobulin Levels in Serum and Ascitic Fluid
Background: We determined complement and immunoglobulin levels in ascitic fluid and serum of 47 patients with spontaneous bacterial peritonitis, malignant ascites, or tuberculous ascites.
Methods: Paracentesis was done to confirm the underlying cause of ascites. Biochemical, hematologic, and microbiologic investigations were also done.
Results: The highest serum and ascitic fluid C3 and C4 levels and ascitic fluid IgM, IgA, and IgG levels were found in patients with tuberculosis. Ascitic fluid C3 level was found to be higher in the tuberculous group than in the patients with spontaneous bacterial peritonitis or malignant ascites. Ascitic fluid C4 levels were higher in patients with tuberculosis than in those with spontaneous bacterial peritonitis.
Conclusion: We believe that further studies of the in vivo kinetics of immunoglobulins and complement in ascitic fluid of various causes are necessary for a better understanding of the host defense mechanisms of these fluids.
Spontaneous bacterial peritonitis (SBP) is a frequent complication of cirrhotic ascites, whereas it is rare in other types of ascites, especially that of malignant origin. Bacteremia is common among patients with severe acute or chronic liver disease. At the time of spontaneous ascitic fluid infection, blood cultures are found to grow bacteria in 54% of patients. Many patients with cirrhosis, especially those with ascites, are complement-deficient. The opsonic activity of the ascitic fluid has been shown to correlate closely with the total protein concentration, and a deficiency of ascitic fluid opsonic activity has been proposed as the factor that results in "susceptible ascites."
The complement components have been shown by several investigators to play an important role in the development of immunologically mediated inflammatory reactions. Several studies in the English-language literature have determined complement and immunoglobulin levels in patients with cirrhosis and spontaneous bacterial peritonitis, but few such studies have been done in patients with tuberculosis. In our study, we measured complement and immunoglobulin levels in serum and ascitic fluid of patients with spontaneous bacterial peritonitis, malignant ascites, and tuberculous peritonitis.
Background: We determined complement and immunoglobulin levels in ascitic fluid and serum of 47 patients with spontaneous bacterial peritonitis, malignant ascites, or tuberculous ascites.
Methods: Paracentesis was done to confirm the underlying cause of ascites. Biochemical, hematologic, and microbiologic investigations were also done.
Results: The highest serum and ascitic fluid C3 and C4 levels and ascitic fluid IgM, IgA, and IgG levels were found in patients with tuberculosis. Ascitic fluid C3 level was found to be higher in the tuberculous group than in the patients with spontaneous bacterial peritonitis or malignant ascites. Ascitic fluid C4 levels were higher in patients with tuberculosis than in those with spontaneous bacterial peritonitis.
Conclusion: We believe that further studies of the in vivo kinetics of immunoglobulins and complement in ascitic fluid of various causes are necessary for a better understanding of the host defense mechanisms of these fluids.
Spontaneous bacterial peritonitis (SBP) is a frequent complication of cirrhotic ascites, whereas it is rare in other types of ascites, especially that of malignant origin. Bacteremia is common among patients with severe acute or chronic liver disease. At the time of spontaneous ascitic fluid infection, blood cultures are found to grow bacteria in 54% of patients. Many patients with cirrhosis, especially those with ascites, are complement-deficient. The opsonic activity of the ascitic fluid has been shown to correlate closely with the total protein concentration, and a deficiency of ascitic fluid opsonic activity has been proposed as the factor that results in "susceptible ascites."
The complement components have been shown by several investigators to play an important role in the development of immunologically mediated inflammatory reactions. Several studies in the English-language literature have determined complement and immunoglobulin levels in patients with cirrhosis and spontaneous bacterial peritonitis, but few such studies have been done in patients with tuberculosis. In our study, we measured complement and immunoglobulin levels in serum and ascitic fluid of patients with spontaneous bacterial peritonitis, malignant ascites, and tuberculous peritonitis.
SHARE
