Journal of Applied Medical Sciences

Strange SAAG: Inappropriately Low Serum-Ascites Albumin Gradient in a 60-year-old Male with Heart Failure and Cirrhosis

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• Abstract

   

  The serum-ascites albumin gradient (SAAG) is a proven diagnostic tool for categorizing ascitic fluid, especially portal hypertension. Cases of low SAAG in the setting of portal hypertension are extremely rare. We present a case of a 60-year-old male with heart failure and liver cirrhosis who had a recurrently low SAAG despite having portal hypertension. Comprehensive workup for ascites should be performed when encountering ascites of unclear origin. Additionally, clinicians should consider other clinical clues beyond the SAAG when the diagnosis is unclear to reach the most plausible diagnosis.

   

  JEL classification numbers: I10, Y5.

  Keywords: Ascites, Cirrhosis, Heart failure, Portal hypertension, Albumin.