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Related Experiment Videos

Patient with markedly elevated CA 19-9 not associated with malignancy.

Douglas Lowe1, Jeffrey Lee, Robert Schade

  • 1Department of Internal Medicine, Section of Gastroenterology/ Hepatology, Medical College of Georgia and Veterans Administration Medical Center, Augusta, GA 30912, USA.

Southern Medical Journal
|March 24, 2006
PubMed
Summary

A markedly elevated cancer antigen 19-9 (CA 19-9) level, often linked to pancreatic cancer, can also result from other conditions like acute cholangitis. This case highlights CA 19-9

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Area of Science:

  • Gastroenterology
  • Oncology
  • Clinical Medicine

Background:

  • Elevated carbohydrate antigen 19-9 (CA 19-9) is a known biomarker for pancreatic carcinoma.
  • However, non-pancreatic causes for elevated CA 19-9 levels are less commonly encountered.

Observation:

  • A 66-year-old male presented with jaundice, pruritus, and significant weight loss.
  • Laboratory tests revealed elevated liver enzymes, total bilirubin, and a markedly high CA 19-9 level (4,374 U/mL).
  • Initial endoscopic retrograde cholangiopancreatography (ERCP) was complicated by duodenal ulceration.

Findings:

  • Successful ERCP with sphincterotomy and balloon sweeping of the common bile duct resolved the patient's jaundice and symptoms.
  • The patient's clinical presentation and laboratory values normalized within five months.

Related Experiment Videos

  • The markedly elevated CA 19-9 level was ultimately attributed to acute cholangitis, not malignancy.

    • Implications:

    • This case underscores the importance of considering differential diagnoses for elevated CA 19-9 levels.
    • It highlights that acute cholangitis can lead to significantly elevated CA 19-9, mimicking pancreatic cancer markers.
    • Clinical correlation and further investigation are crucial when interpreting high CA 19-9 levels, especially in the absence of confirmed malignancy.