Volume 19, Issue 1 (April 2012)                   J Birjand Univ Med Sci 2012, 19(1): 122-126 | Back to browse issues page

XML Persian Abstract Print


Download citation:
BibTeX | RIS | EndNote | Medlars | ProCite | Reference Manager | RefWorks
Send citation to:

Mokhtarifar A, Fakharian T, Mokhtari E. Extraordinary elevated CA19-9 in patient with common bile duct stones and cholangitis Case report . J Birjand Univ Med Sci 2012; 19 (1) :122-126
URL: http://journal.bums.ac.ir/article-1-987-en.html
1- Emam Reza hospital, department of internal medicine, Mashhad University of Medical Sciences, Mashhad, Iran.
2- Ghaem and Emam Reza hospitals, department of internal medicine, Mashhad University of Medical Sciences, Mashhad, Iran. , t.fakharian@gmail.com
3- Ghaem and Emam Reza hospitals, department of internal medicine, Mashhad University of Medical Sciences, Mashhad, Iran.
Abstract:   (100324 Views)

Serum Carbohydrate Antigen, CA19-9, is a carbohydrate antigen whose usage -as a tumor marker- in pancreatic and bile ducts malignancies is commonly increasing. Sensitivity and specificity of this antigen in the diagnosis of malignancies is 70-90% and 68-91%, respectively. CA19-9 can also rise in other disorders and in few of benign conditions including cholangitis, due to other causes, e.g. choledocholithiasis. However, in such cases the increase is not significant and it is usually below 1000 u/ml. Values more than 10000 u/ml are limited to few case reports in articles. The case under study was a 66 year old man hospitalized because of epigastric and right upper quadrant pain, fever, jaundice, acholic stool, weight loss of about 6 kg, and hyperchromic urine. Physical examination revealed that the case was icteric and febrile with a mild RUQ tenderness on percussion. Laboratory tests showed marked elevation of bilirubin and CA19-9 (Total bilirubin: 36 mg/dl, Direct: 19.5 mg/dl CA19-9 :44777u/ml, Normal: 0-40 u/ml), but the enzymes of the liver and alkaline phosphatase only increased to two times the normal level. Sonography showed dilated common bile duct with four stones within it. Four weeks after stones extraction and renewal of bile current CA19-9 fell to 60 u/ml and returned to normal range (0-40) 2 months later and during this period the patient was totally asymptomatic. As a result, in patients with biliary obstruction, a diagnosis of malignancy cannot be made solely on the basis of increased concentration of CA19-9, even in case of high clinical suspicion and the interpretation of this increase must be done with more caution and after lab follow-up following removal of the obstruction.

Full-Text [PDF 357 kb]   (5533 Downloads)    
Type of Study: Case Report | Subject: Gastroenterology
Received: 2011/11/25 | Accepted: 2012/02/29 | ePublished: 2016/03/10

Add your comments about this article : Your username or Email:
CAPTCHA

Send email to the article author


Rights and permissions
Creative Commons License This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.

© 2024 CC BY-NC 4.0 | Journal of Birjand University of Medical Sciences

Designed & Developed by : Yektaweb