[Hemopexin and immunoglobulins in benign and malignant ascites. Experience in 66 patients]

Sixty six patients with ascites of different etiologies were studied. Both serum and peritoneal fluids were examined through proteic electrophoresis, being the haemopexin determined in the peritoneal fluids. Immunoglobulins usually show high values in neoplastic effusions, especially igG (x +/- ES = 928.57 +/- 86.87 mg/dl) and IgA (x +/- ES = 157 +/- 17.84 mg/dl). However, the highest determinations were found in those of the congestive heart failures. The quotients obtained from the ascites immunoglobulin/serum immunoglobulin ratio are useful from a statistics point of view, though their practical value is limited. No plasma/ascites correlation was observed either in cirrhotic or in neoplastic patients. Quantification of haemope in proved to be conclusive in differential diagnosis. The 100% of benign ascites (cirrhosis, congestive heart failure and kidney failure) showed lower values than 170 mg/dl while 90.5% of neoplastic patients showed higher figures than said value. The average was 30.79 +/- 5.31 mg/dl for cirrhotic patients and 205.19 +/- 9.62 mg/dl for neoplastic patients with a statistically significative different for both groups (p less than 0.001). There is a high probability that its determination could show the etiology of the process. It was useful not only in cases of both neoplastic and cirrhotic ascites but also in those which had a cardiac origin, in which it showed intermediate values (mean +/- ES = 83.75 +/- 15.77 mg/dl). We feel that its incorporation to the routine followed when studying peritoneal effusions will afford a quick etiologic orientation.