The difference in clinical and conventional laboratory features between tuberculous peritonitis and peritoneal carcinomatosis

S. M. Peng*, C. M. Chu, S. S. Wu, S. M. Lin

*Corresponding author for this work

Research output: Contribution to journalJournal Article peer-review

1 Scopus citations

Abstract

The difference in the clinical and conventional laboratory features between tuberculous peritonitis and peritoneal carcinomatosis was retrospectively analysed in 25 patients with tuberculous peritonitis, and 58 patients with peritoneal carcinomatosis proved by peritoneoscopic and histopathological examination, from Jan. 1985 to Dec. 1990. The clinical features revealed no significant difference except that fever was much more prevalent in tuberculous peritonitis than in peritoneal carcinomatosis (64% vs 12%, P < 0.005). Chest X-ray suggestive of pulmonary tuberculosis was found in 28% of patients was tuberculous peritonitis, but in only 3% of patients with peritoneal carcinomatosis (P < 0.05). Serum albumin was lower (2.7 ± 0.68 gm/dL vs 3.1 ± 0.53 gm/dL, P < 0.05) but globulin higher (4.1 ± 0.77 gm/dL vs 3.1/0.67 gm/dL, P < 0.005) in tuberculous peritonitis than in peritoneal carcinomatosis. Fourteen (56%) of 25 patients with tuberculous peritonitis, and only 3 (5%) of 58 patients with, and only 3 (5%) of 58 patients with peritoneal carcinomatosis, had a serum globulin-albumin gradient higher than 1.3 gm/dL (P < 0.005). Other laboratory data, such as WBC and its classification, RBC, ESR, ALT, and Alk-P, showed no significant difference. Serum CEA was elevated (> 4 ng/ml) in 50% (20/40) of patients with peritoneal carcinomatosis but only in 6% (1/16) of patients with tuberculous peritonitis (P < 0.005). The result of ascites examination, including WBC and its classification, RBC, sugar, LDH, lactate, and total protein showed no significant difference. Ascites cytology was positive in 44% (22/50) of patients with peritoneal carcinomatosis, and culture of tuberculous bacilli was positive in 4.3% (1/23) of patients with tuberculous peritonitis. In conculsion, the clinical and laboratory features of tuberculous peritonitis and peritoneal carcinomatosis often overlapped, but a history of fever, serum albumin, globulin, globulin-albumin gradient (> 1.3 gm/dL), CEA, and chest X-ray examination might help in their initial differential diagnosis.

Original languageEnglish
Pages (from-to)163-167
Number of pages5
JournalChinese Journal of Gastroenterology
Volume9
Issue number2
StatePublished - 1992
Externally publishedYes

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