Identification and estimation of leucine aminopeptidase activity in the serum and ascitic fluid of patients with schistosomiasis

The activity and electrophoretic mobility or leucine aminopeptidase [LAP] were assessed in the sera of 100 patients with different clinical stages of Schistosoma hacmatobium infestation as well as in 20 sample of ascctic fluids obtained from patients with bilharzial hepatosplenomegaly associated with ascites matched with 20 healthy adult males sample as control. Generally LAP activity was significantly higher in all patients. The activity of serum LAP showed a progressive rise with the advance in the clinical condition. The highest level was encountered in the sera of patients with bladder carcinoma and liver metastasis, leucine aminopeptidase was considerably found in the ascetic fluid. The ratio of the activity or LAP in the ascetic fluid to its activity in the serum of the same patients was 1:4.5 where the enzyme diffuses from the blood to the ascetic fluid. The enzyme detected by electrophoresis, in serum or ascetic fluid LAP migrated as a single component in the alpha1 -globulin faction. The results are discussed and compared with those in the literature

Elderly lady with ascites.

An elderly lady with amylase-rich ascites is presented, whose isoenzyme estimation revealed salivary type amylase. Tumour hyperamylasemia is an important group among the nonpancreatic causes of elevated amylase.

Aspectos bioquímicos do plasma e fluido peritoneal de eqüinos com cólica / Biochemical aspects of plasma and peritoneal fluid from horses with colic

Compararam-se as características do plasma e do fluido peritoneal entre 6 eqüinos clinicamente sadios com as de outros 16 eqüinos com cólica. Encontrou-se uma elevaçäo significante na taxa de proteínas plasmáticas totais e na concentraçäo do fosfato inorgânico nos eqüinos com cólica. Este fato esteve diretamente relacionado a lesöes isquêmicas intestinais. Assim, conclui-se que algumas alteraçöes bioquímicas do plasma e do fluido peritoneal, quando analisadas em conjunto com os dados obtidos no exame clínico, säo bons indicadores da severidade do caso

Pancreatic ascites.

Pancreatic ascites is rarely considered in the differential diagnosis of exudative ascites, and is in fact missed in a majority of patients. Eleven cases of pancreatic ascites are described. 63.6% were chronic alcoholics. The clinical diagnosis was cirrhosis of liver (5/11), tuberculous peritonitis (5/11) or malignant peritonitis (1/11). In all patients ascites was exudative and the ascitic fluid amylase was markedly elevated (mean +/- SD: 7815 +/- 6507 SU/dl). Endoscopic retrograde pancreatography (ERP) performed in 4 patients demonstrated the site of leak in 3. Laparoscopy performed in 8 patients helped in the diagnosis of pancreatic ascites in all, which was confirmed on histology. Laparoscopy ruled out other causes of exudative ascites in all. We conclude that pancreatic ascites should be suspected in any patient with exudative ascites, especially chronic alcoholics and that ascitic fluid amylase should be routinely performed in all such cases. High ascitic fluid content is virtually diagnostic of pancreatic ascites. ERP is essential in preoperative assessment or planning endoscopic treatment. Laparoscopy is an invaluable investigation to rule out other conditions such as tuberculous or malignant peritonitis and cirrhosis of liver.

Poor diagnostic value of adenosine deaminase in pleural, peritoneal & cerebrospinal fluids in tuberculosis.

Adenosine deaminase (ADA) was estimated in 84 pleural, 140 peritoneal and 136 cerebrospinal fluids to study its diagnostic usefulness as a routine test for tuberculosis. The sensitivity, specificity, positive and negative predictive values for diagnosing tuberculosis in pleural fluids (ADA > 30 U/l) was 67, 92, 78 and 87 per cent respectively, in peritoneal fluids (ADA > 15 U/1) it was 89, 81, 25 and 99 per cent respectively and in cerebrospinal fluids (ADA > 10 U/l) it was 50, 90 21 and 97 per cent respectively. The differences in mean ADA levels between tuberculous (28.0 and 19.5 U/1) and non-tuberculous (9.7 and 4.8 U/1) peritoneal and cerebrospinal fluids although statistically significant (P < 0.001), were of no practical clinical value. A wide scatter in ADA values was seen in both tuberculous and non-tuberculous fluids. ADA estimation in plasma, lymphocytes and cell fractions of fluids was also not diagnostically useful nor did it throw light on the source of elevated ADA in fluids.

Diagnostic evaluation of ascitic adenosine deaminase activity in tubercular peritonitis.

Activity of adenosine deaminase (ADA) in serum and peritoneal fluid was studied prospectively in 24 aetiologically proved cases of ascites and 10 age-matched controls. Patients were divided into 3 groups according to causes of ascites, viz. malignant ascites (11), tubercular peritonitis (7) and cirrhosis of liver (6). Serum ADA values and peritoneal: serum ADA ratio did not show any consistent pattern in any group. But in patients with tubercular peritonitis ADA activity in ascitic fluid was significantly higher (P < .001) than in the other groups. An ascitic ADA level of 30 units/L had a sensitivity of 100% and specificity of 94.1% for tubercular peritonitis. These findings suggest that the ascitic fluid ADA activity is useful for the diagnosis of tubercular peritonitis; this method is simple and least invasive.