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Role of cholesterol determination in ascitic fluid analysis

✍ Scribed by Alexander L. Gerbes; Dieter Jüngst

Publisher
John Wiley and Sons
Year
2009
Tongue
English
Weight
41 KB
Volume
50
Category
Article
ISSN
0270-9139

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✦ Synopsis

We read with interest the recent article by Runyon on diagnosis and treatment of ascites. 1 Surprisingly, determination of cholesterol in ascitic fluid was classified as being unhelpful (table 3 of the article). The value of cholesterol in the differentiation between cirrhotic and malignant ascites was first demonstrated in this journal. 2 Consequently, we compared cholesterol with other ascitic fluid parameters including the serum-ascites albumin gradient and found it superior. 3 Furthermore, we suggested a pathomechanism for the increase of ascitic cholesterol in malignant ascites. 4 The diagnostic value of this simple and cheap parameter was confirmed by several groups. [5][6][7][8] Thus, according to the grading system used in this article, cholesterol should be recommended as Class I, Level B. In our opinion, guidelines should be based on a careful review of the existing literature and free of personal bias. May we suggest that the guidelines be corrected accordingly.

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