Paracentesis vs. intraperitoneal reinfusion of concentrated ascites — effect on opsonic activity of ascites
| Autor: | Pavel Kuklínek, Jiří Prášek, Jan Lata, Libuše Husová, Ivo Novotný |
|---|---|
| Rok vydání: | 1999 |
| Předmět: |
0303 health sciences
medicine.medical_specialty Cirrhosis medicine.diagnostic_test business.industry medicine.disease Gastroenterology 3. Good health 03 medical and health sciences Specific antibody 0302 clinical medicine Spontaneous bacterial peritonitis Internal medicine Immunology Ascites Internal Medicine Paracentesis medicine 030211 gastroenterology & hepatology Refractory ascites medicine.symptom Complication business Opsonin 030304 developmental biology |
| Zdroj: | European Journal of Internal Medicine. 10:209-213 |
| ISSN: | 0953-6205 |
| Popis: | Background. Spontaneous bacterial peritonitis is a frequent and serious complication of cirrhotic ascites. An important defense mechanism of ascites against infection is opsonic activity, where the most important part is played by specific antibodies and C3 and C4 components of complement. The authors wanted to find out whether reinfusion of concentrated ascites or paracentesis can influence this activity. Methods. Twenty-six patients with cirrhosis of the liver and refractory ascites not corresponding to salt restriction and diuretics were divided into two groups. In 14 patients, a total of 25 therapeutic paracenteses were made; in 12 patients, a total of 19 reinfusions of concentrated ascites were performed intraperitoneally. In all patients, levels of IgG, IgA, IgM, C3 and C4 components of complement were assessed in ascites before and 24 h after the intervention. Results. After paracentesis no change of the investigated parameters was found. Reinfusion of concentrated ascites, on the other hand, led to a significant rise of IgG, IgA, IgM, C3 and C4 at the 0.5% level of significance. Conclusion. Treatment of refractory ascites by ultrafiltration and reinfusion intraperitoneally seems to increase opsonic activity of ascites and could be useful in the prevention of the development of spontaneous bacterial peritonitis. |
| Databáze: | OpenAIRE |
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