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Tuberculous peritonitis mimicking peritonitis carcinomatosis: a case report
Jia-Feng Wu1, Hwa-Jung Li, Ping-Ing Lee
1Department of Paediatrics, National Taiwan University Hospital, No. 7 Chung-Shan S. Road, Taipei, Taiwan.
European Journal of Pediatrics
|October 10, 2003
Summary
Tuberculous peritonitis, initially suspected as peritonitis carcinomatosis due to elevated cancer antigen-125 (CA-125), was diagnosed via laparoscopy. CA-125 levels decreased with anti-tuberculosis treatment, indicating its potential as a marker for disease activity.
Area of Science:
- Infectious Diseases
- Oncology
- Gastroenterology
Background:
- Tuberculous peritonitis is a significant cause of morbidity, particularly in endemic areas.
- It often presents with non-specific symptoms mimicking other abdominal pathologies, complicating diagnosis.
- Elevated cancer antigen-125 (CA-125) is typically associated with ovarian cancer but can be raised in other conditions.
Observation:
- A 13-year-old female presented with symptoms suggestive of peritonitis, including fever and abdominal distension.
- Imaging revealed omental cake and peritoneal thickening, leading to initial suspicion of peritonitis carcinomatosis.
- Significantly elevated serum CA-125 levels (1248.5 U/ml) were noted.
Findings:
- Diagnostic laparoscopy identified peritoneal tubercles, and pathology confirmed granulomatous inflammation.
- Ascitic fluid culture isolated Mycobacterium tuberculosis, establishing the diagnosis of tuberculous peritonitis.
- Following anti-tuberculosis treatment, the patient's symptoms resolved, and CA-125 levels decreased to 10.2 U/ml.
Implications:
- This case highlights the diagnostic challenge of tuberculous peritonitis, especially when presenting with elevated CA-125.
- Serum CA-125 levels may serve as a valuable non-invasive marker for monitoring disease activity and treatment response in tuberculous peritonitis.
- Further research is warranted to validate CA-125 as a reliable biomarker in this condition.