title: Diagnostic feature of tuberculous peritonitis in patients with cirrhosis: A matched case-control study.
abstract: The aim of the present study was to compare the clinical characteristics of tuberculous peritonitis (TBP) and spontaneous bacterial peritonitis (SBP) in patients with cirrhosis. A retrospective, matched case-control study was conducted consisting of 12 patients with cirrhosis diagnosed with TBP between 2008 and 2011. Control subjects were patients with SBP. Clinical features and laboratory data were analyzed. Compared with SBP, TBP in patients with cirrhosis was frequently associated with extraperitoneal tuberculosis (25 vs. 0%), a more insidious onset (39.67±30.00 vs. 21.60±21.50 days; P<0.05), Child-Pugh classification B at onset (67 vs. 32%; P<0.05) and lymphopenia (0.67±0.22 vs. 1.19±0.41×109/l; P<0.01). Patients with TBP tended to have lymphocytic predominance in the peritoneal fluid (92%), while patients with SBP tended to have neutrophil predominance (68%). Compared with the SBP group, the TBP group had significantly higher ascitic protein, adenosine deaminase (ADA) and lactate dehydrogenase (LDH) levels. Ascitic protein levels were >25 g/l in 9 patients (75%) in the TBP group and in 2 patients (8%) in the SBP group; ascitic ADA activity levels were >27 U/l in 8 patients (67%) in the TBP group, but were not >27 U/l in any of the patients in the SBP group; ascitic LDH levels were >90 U/l in 10 patients (83%) in the TBP group and 5 patients (20%) in the SBP group. Therefore, the results of the present study indicate that TBP should be considered in cirrhotic patients with relevant clinical manifestations and characteristics of laboratory observations.
authors.affiliation: Department of Infectious Disease, Zhejiang Provincial People's Hospital, Hangzhou, Zheijiang 310014, P.R. China.
authors.forename: Hai-Jun
authors.initials: HJ
authors.lastname: Huang
authors.affiliation: Department of Medicine, Blood Center of Zhejiang Province, Hangzhou, Zheijiang 310061, P.R. China ; Transform Medicine Center, Affiliated Hospital of Hangzhou Normal University, Hangzhou, Zheijiang 310015, P.R. China.
authors.forename: Jin
authors.initials: J
authors.lastname: Yang
authors.affiliation: Department of Infectious Disease, Zhejiang Provincial People's Hospital, Hangzhou, Zheijiang 310014, P.R. China.
authors.forename: Yi-Cheng
authors.initials: YC
authors.lastname: Huang
authors.affiliation: Department of Infectious Disease, Zhejiang Provincial People's Hospital, Hangzhou, Zheijiang 310014, P.R. China.
authors.forename: Hong-Ying
authors.initials: HY
authors.lastname: Pan
authors.affiliation: Department of Infectious Disease, Zhejiang Provincial People's Hospital, Hangzhou, Zheijiang 310014, P.R. China.
authors.forename: Hong
authors.initials: H
authors.lastname: Wang
authors.affiliation: Department of Respiratory Medicine, Zhejiang Provincial People's Hospital, Hangzhou, Zheijiang 310014, P.R. China.
authors.forename: Zhuo-Chao
authors.initials: ZC
authors.lastname: Ren
keywords: liver cirrhosis; spontaneous bacterial peritonitis; tuberculous peritonitis