title: Differentiation of tuberculous peritonitis from peritonitis carcinomatosa without surgical intervention.
abstract: OBJECTIVE
  Ascites of tuberculous peritonitis (TBP) is an exudative type and may well be misdiagnosed as carcinomatous peritonitis, especially in the elderly. The aim of this study was to identify independent predictors that can differentiate TBP from peritonitis carcinomatosa without surgical intervention.
  
  
  METHODS
  This prospective cohort study was performed on 75 subjects in the following groups: TBP (n=27) (TBP group), ovarian cancer complicated with ascites (n=24) (Ov Ca group), and gastric cancer complicated with ascites (n=24) (Ga Ca group). The frequency of clinical symptoms, laboratory parameters, and serum tumor markers levels were compared.
  
  
  RESULTS
  In univariate analysis; fever, night sweats, and abdominal pain were significantly more frequent in the TBP group compared to those in the Ov Ca group (P < 0.001, P < 0.001, and P = 0.035, respectively) and the Ga Ca group (P < 0.001, P < 0.001, and P = 0.015, respectively). Serum CA 19-9 and carcino embryonic antigen (CEA) levels were significantly lower in the TBP and Ov Ca group compared to the Ga Ca group (P < 0.001 and P < 0.001, respectively). Elevated serum CA 125 level was found in all patients with TBP and Ov Ca and in 86.6% of patients with Ga Ca. In the multivariate analysis, presence of fever (P < 0.001), night sweats (P < 0.001), age under 40 years (P = 0.008), and normal serum CA 19-9 level (P = 0.044) were independent predictor of diagnosis of TBP.
  
  
  CONCLUSIONS
  The presence of fever, elevated serum CA 125 level, normal serum CA 19-9, and CEA associated with lymphocyte predominant benign ascites may establish the diagnosis of TBP.
authors.affiliation: Department of Gastroenterology, Dicle University School of Medicine, Diyarbakir, Turkey. muhsinkaya20@hotmail.com
authors.forename: Muhsin
authors.initials: M
authors.lastname: Kaya
authors.forename: Mehmet A
authors.initials: MA
authors.lastname: Kaplan
authors.forename: Abdurrahman
authors.initials: A
authors.lastname: Isikdogan
authors.forename: Yusuf
authors.initials: Y
authors.lastname: Celik
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015415:Biomarkers / Q000097:blood; D018394:CA-125 Antigen / Q000097:blood*; D002272:Carcinoembryonic Antigen / Q000097:blood*; D000075202:Contraindications; D003937:Diagnosis, Differential; D003951:Diagnostic Errors; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D010535:Laparoscopy; D007813:Laparotomy; D008297:Male; D008875:Middle Aged; D019152:Paracentesis / Q000379:methods*; D010534:Peritoneal Neoplasms / Q000097:blood / Q000175:diagnosis*; D014395:Peritonitis, Tuberculous / Q000097:blood / Q000175:diagnosis*; D011446:Prospective Studies; D015203:Reproducibility of Results; D055815:Young Adult
chemical_list: D015415:Biomarkers; D018394:CA-125 Antigen; D002272:Carcinoembryonic Antigen