What is the role of lab testing in the diagnosis of Budd-Chiari syndrome?

Updated: Oct 10, 2018
  • Author: Praveen K Roy, MD, AGAF; Chief Editor: BS Anand, MD  more...
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Evaluate patients with Budd-Chiari syndrome for underlying predisposing conditions, such as malignancy or hypercoagulable states, and institute appropriate therapy.

Examination of the ascitic fluid provides useful clues to the diagnosis, including the following:

  • Patients usually have high protein concentrations (>2 g/dL); this may not be present in persons with the acute form of Budd-Chiari syndrome

  • The white blood cell (WBC) count is usually less than 500/µL

  • The serum ascites–albumin gradient is usually less than 1.1 (except in the acute forms of the disease)

Routine biochemical test results are usually nonspecific in Budd-Chiari syndrome, although mild elevations in serum aminotransferase and alkaline phosphatase levels are present in 25-50% of patients.

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