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Serum to Ascites Albumin Gradient

The application of Light's criteria for classifying transudates and exudates is often misleading when applied to peritoneal fluid (ascites). The measurement of albumin in ascitic fluid as a surrogate marker of portal hypertension has largely replaced the practice of distinguishing transudates from exudates. Calculation of a serum to ascites albumin gradient (SAAG) is a more physiologically appropriate test.  It is calculated as the serum albumin concentration minus the peritoneal fluid albumin.  A high gradient (>1.1 g/dL) indicates ascites related to portal hypertension, usually due to cirrhosis. Increased hydrostatic pressure within hepatic portal veins forces water, but not large proteins such as albumin, into the peritoneal cavity. Heart failure can also produce a high gradient. A low gradient <1.1 g/dL is usually associated with peritoneal seeding by cancer, tuberculosis and other infections. 

Updated Articles

Platelet…

Platelet transfusion refractoriness (PTR) is defined as the occurrence of at least two poor incremental platelet counts after transfusion of a standard dose of platelet s. PTR is classified as either immune or nonimmune. Immune-mediated PTR is…

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Factor VIII…

Factor VIII is a large glycoprotein cofactor with a molecular weight of 320 kilodaltons that is synthesized mainly in hepatocytes, but also in hepatic macrophages, megakaryocytes, and endothelial cells. Factor VIII circulates in plasma bound to von…

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Hematology Hashtag…

Twitter is becoming an increasingly valuable tool for discovery of fascinating case studies, communicating with colleagues and keeping abreast of the most recent advancements in all subspecialties of Pathology. In March 2017, ClinLabNavigator…

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Cases That Kept Me Up At Night: Case #1

Case #1 is an overview of transfusion reactions and a discussion of a neonate with both NAIT and Rh HDN.

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