Diagnostic value of blood and ascitic fluid concentrations of fibronectin, cholesterol and apolipoproteins in differentiation between malignant and non-malignant ascites

Sixty patients [28 males and 32 females] with ascites of unknown cause were examined. Their age ranged from 15 to 70 years, with a mean age of 42 years. The patients were classified into malignant ascites group [25 patients] and sterile uncomplicated ascites group [35 patients]. Patients with both malignant disease and liver cirrhosis were excluded. Serum and ascitic fluid discriminating value for tested parameters were calculated as follows: Serum apo-A 1.9 g/L, plasma fibronectin 13 mg/dL, ascitic proteins 51.6 g/L, ascitic albumin 33.9 g/L, ascitic apo-A 0.8 g/L, ascitic apo-A-I 0.8 g/L, ascitic cholesterol was 97.9 mg/dL, ascitic triglyceride 66.5 mg/dL, ascitic HDL 0.45 g/L, ascitic LDL 65.5 mg/dL, A/S protein ratio 0.7 and A/S apo A-I ratio 0.9. Ascitic proteins and serum-ascitic albumin concentration gradient failed to show remarkable discriminating value between both types of ascites. Meanwhile, ascitic-serum protein ratio showed better sensitivity [65%] than ascitic total proteins [45%] and serum-ascitic albumin gradient [35%]. Ascitic proteins despite their rather low specificity, had good positive predictive value [75%]

HLA antigen phenotypes in rheumatic heart disease

The pattern of human leucocyte antigen [HLA] phenotypes [HLA-A, -B and -DR antigens] was typed in 80 upper Egyptian patients with established rheumatic valvular heart disease and the results were compared with those of 200 ethnically similar normal controls. The results of the present study suggested that RHD in population may be influenced by the HLA associated genetic susceptibility. Recent studies have been recently begun to probe the monoclonal technology which revealed the existence of a serologically defined strong genetic marker [B-lymphocyte alloantigen]. The predictive value of this antigen in predicting the risk of various factors of acute rheumatic fever [ARG] and RHD, needs to be evaluated to better recognize and quantitate the different lymphocyte subsets to enable production of selective and effective immunosuppressive therapy [at an earlier stage] of this disabling heart disease