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

Douglas Lowe, Jeffrey R Lee, Robert Schade, Ayaz Chaudhary

Research output: Contribution to journalArticle

9 Citations (Scopus)

Abstract

A 66-year-old white male presented with jaundice, pruritus, and a 30-pound weight loss over two months. Physical examination revealed scleral icterus. Laboratory evaluation revealed ALT 161 U/L, AST 290 U/L, alkaline phosphatase 2004 U/L, GGT 2,552 U/L, total bilirubin 10.2 mg/dL, and a carbohydrate antigen 19-9 (CA 19-9) level of 4,374 U/mL. Initial endoscopic retrograde cholangiopancreatography (ERCP) was unsuccessful due to ulceration in the duodenum healed with esomeprazole therapy. Subsequent ERCP showed a possible filling defect in the common bile duct treated with sphincterotomy and balloon sweeping of the common bile duct. Symptoms and jaundice resolved five months after initial presentation with normal labs and studies. While elevated CA 19-9 levels occur in most patients with carcinoma of the pancreas, it can also be elevated in patients with extrapancreatic malignancies and acute cholangitis. This case illustrates the fact that a markedly elevated CA 19-9 can be secondary to causes other than carcinoma.

Original languageEnglish (US)
Pages (from-to)306-308
Number of pages3
JournalSouthern Medical Journal
Volume99
Issue number3
DOIs
StatePublished - Mar 1 2006

Fingerprint

Jaundice
Endoscopic Retrograde Cholangiopancreatography
Carbohydrates
Common Bile Duct
Antigens
Esomeprazole
Carcinoma
Neoplasms
Cholangitis
Pruritus
Duodenum
Bilirubin
Physical Examination
Alkaline Phosphatase
Weight Loss
Pancreas
Therapeutics

Keywords

  • Carbohydrate antigen 19-9 (CA 19-9)
  • Jaundice
  • Pancreatic cancer

ASJC Scopus subject areas

  • Medicine(all)

Cite this

Patient with markedly elevated CA 19-9 not associated with malignancy. / Lowe, Douglas; Lee, Jeffrey R; Schade, Robert; Chaudhary, Ayaz.

In: Southern Medical Journal, Vol. 99, No. 3, 01.03.2006, p. 306-308.

Research output: Contribution to journalArticle

Lowe, Douglas ; Lee, Jeffrey R ; Schade, Robert ; Chaudhary, Ayaz. / Patient with markedly elevated CA 19-9 not associated with malignancy. In: Southern Medical Journal. 2006 ; Vol. 99, No. 3. pp. 306-308.
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