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Tuberculous peritonitis with extraordinarily high serum CA125
1Third Department of Internal Medicine, Fukushima Medical College, Japan.
Journal of Medicine
|January 1, 1992
Summary
Elevated cancer antigen 125 (CA125) levels in a patient with ascites were linked to peritoneal tuberculosis. Treatment for tuberculosis led to a decrease in CA125 and ascites.
Area of Science:
- Oncology
- Infectious Diseases
- Gastroenterology
Background:
- Ascites and elevated serum cancer antigen 125 (CA125) are common clinical findings.
- Differential diagnosis for ascites with elevated CA125 includes malignancy and other inflammatory conditions.
Observation:
- A 74-year-old woman presented with ascites and markedly elevated serum CA125.
- Laparoscopy revealed peritoneal nodules consistent with tuberculomas.
- Biopsy confirmed epithelioid cells and Langhans-type giant cells.
Findings:
- Serum CA125 levels decreased with diuretic treatment for ascites.
- Antituberculosis treatment resulted in a further significant reduction in CA125.
- Despite clinical signs, mycobacteria were not detected in specimens.
Implications:
- Peritoneal tuberculosis can cause elevated serum CA125 levels and ascites.
- Tuberculous peritonitis should be considered in unexplained CA125 elevations.
- This case highlights the importance of considering infectious etiologies in ascites management.