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In Reply Dr Witte discusses the pathophysiological mechanisms that result in differential protein ascites content in cirrhosis and heart failure states. In our JAMA Diagnostic Test Interpretation article, we suggested the pattern of high-protein content ascites in our patient was secondary to the permeable nature of hepatic sinusoids in chronic heart failure, which is substantiated by the pioneering work of Witte.1
Patel YA, Muir AJ. Mechanisms of Ascites Development—Reply. JAMA. 2016;316(17):1829. doi:10.1001/jama.2016.15072
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