[Ascites with high protein concentration 2 months after C-section delivery: diagnosis using adenosine deaminase analysis combined with iconography].
We report the case of a 38-year-old woman, born and raised in Congo, in France for 7 years, who developed ascites 2 months after delivery by C-section. Thrombopenia at 95,000 elements per millimeter cube was diagnosed during her pregnancy and her obstetrician initiated a treatment with corticosteroids. Analysis of the ascitic fluid showed a high concentration of proteins (55.7 g/l), with 2000 elements, 80% of which were lymphocytes, and very high levels of adenosine deaminase. Thoracoabdominal tomodensitometry revealed ascites, a multinodular spleen, and hyperemia of the peritoneum; but the liver and the lungs were normal and no adenoma was identified. Laparoscopy was not performed and the suspected diagnosis of peritoneal tuberculosis was confirmed by only one culture of ascitic fluid.
Service de médecine interne, CHG de Dourdan, 2, rue du Potelet, 91410 Dourdan cedex, France.
H
H
Kassem
T
T
El Gharbi
E
E
Dresco
I
I
Leroux
A
A
Hervouet
L
L
Turner
D000243:Adenosine Deaminase / Q000097:blood; D000328:Adult; D001201:Ascites / Q000097:blood / Q000175:diagnosis* / Q000201:enzymology; D002585:Cesarean Section / Q000009:adverse effects*; D003223:Congo; D003287:Contrast Media; D005260:Female; D006801:Humans; D014395:Peritonitis, Tuberculous / Q000097:blood / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000188:drug therapy; D011247:Pregnancy; D013154:Spleen / Q000000981:diagnostic imaging; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome
D003287:Contrast Media; D000243:Adenosine Deaminase