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Related Experiment Video

Updated: Sep 12, 2025

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Elevated CA19-9 in IgG4-related disease.

Derrick Chong1, Andre Mattman2, Aaron Dou1

  • 1Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada.

Annals of Clinical Biochemistry
|August 8, 2025
PubMed
Summary
This summary is machine-generated.

Elevated carbohydrate antigen 19-9 (CA19-9) in IgG4-related disease (IgG4-RD) is not due to serum IgG4 interference. This finding suggests elevated CA19-9 in IgG4-RD is disease-related, not from biliary obstruction.

Keywords:
Carbohydrate antigen 19-9autoimmune pancreatitisimmunoglobulin G4-related diseasepancreatic cancer

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Area of Science:

  • Immunology
  • Gastroenterology
  • Oncology

Background:

  • Immunoglobulin G4-related disease (IgG4-RD) can mimic pancreatic and hepatobiliary cancers.
  • Serum carbohydrate antigen 19-9 (CA19-9) is a key marker for biliary cancer diagnosis.
  • Elevated CA19-9 has been observed in patients with IgG4-RD.

Purpose of the Study:

  • To investigate if serum IgG4 interferes with CA19-9 measurements.
  • To determine the relationship between CA19-9 levels and IgG4-RD.
  • To explore potential causes of elevated CA19-9 in IgG4-RD patients.

Main Methods:

  • Quality assurance analysis of paired IgG4 and CA19-9 measurements.
  • In vitro mixing studies to assess IgG4 interference with CA19-9 assays.
  • Retrospective chart review comparing IgG4-RD patients with normal vs. elevated CA19-9.

Main Results:

  • No association was found between serum IgG4 and CA19-9 levels in 487 individuals.
  • Mixing studies confirmed no interference of high IgG4 on CA19-9 measurements.
  • Among 20 IgG4-RD patients, 11 had elevated CA19-9; no significant difference in bilirubin levels was observed between groups.

Conclusions:

  • Serum IgG4 does not interfere with CA19-9 measurements.
  • Elevated CA19-9 in IgG4-RD is likely related to the disease process itself.
  • The findings differentiate IgG4-RD from biliary obstruction in the context of elevated CA19-9.