Wallach's Interpretation of Diagnostic Tests: Pathways to Arriving at a Clinical Diagnosis (135 page)

PANCREATIC DISEASE

   AF amylase level greater than serum amylase level is specific for pancreatic disease, but both levels are normal in 10% of cases.

   Methemalbumin in serum or AF and total protein >4.5 g/dL indicate poor prognosis.

MALIGNANT ASCITES

   Increased fluid cholesterol (>45 mg/dL) and fibronectin (>10 mg/dL) have S/S 90%/82%.

   Positive cytology has S/S 70%/100%.

   Increased AF CEA (>2.5 mg/dL) has S/S 45%/100%.

ASCITES IN FETUS OR NEONATE

   Causes

   Nonimmune (occurs in 1 in 3,000 pregnancies)

   Cardiovascular abnormalities causing CHF (e.g., structural, arrhythmias) (40% of cases)

   Chromosomal (e.g., Turner and Down syndromes are most common; trisomy 13, 15, 16, and 18) (10–15% of cases)

   Hematologic disorders (any severe anemia) (10% of cases)

   Inherited (e.g., α-thalassemia, hemoglobinopathies, G6PD deficiency)

   Acquired (e.g., fetal–maternal hemorrhage, twin-to-twin transfusion, congenital infection [parvovirus B19], methemoglobinemia)

   Congenital defects of the chest and abdomen.