Normalisation of high CA 19-9 values in autoimmune hepatitis after steroidal treatment.
Carbohydrate 19-9 antigen (CA 19-9) is considered a specific marker of pancreatobiliary adenocarcinomas, but slight increase of its levels can be found in several non-malignant diseases of the liver, such as autoimmune hepatitis. We describe a case of marked CA 19-9 elevation (up to 898.0 U/ml) in a patient with autoimmune hepatitis. Laboratory and instrumental examinations excluded malignant diseases. Immunohistochemical analysis for CA 19-9 and MIB-1, performed on liver biopsy, showed reactivity in inflammatory areas, in particular in bile ductule cells and hepatocytes in ductular metaplasia, suggesting that these cells could be involved in CA 19-9 serum levels increase. After steroids, the clinical picture improved and all the laboratory parameters normalised.
Montalto
M
M
Department of Internal Medicine, Catholic University, Rome, Italy. mmontalto@rm.unicatt.it
Santoro
L
L
Vastola
M
M
Curigliano
V
V
Ricci
R
R
Vecchio
F M
FM
Manna
R
R
Gasbarrini
G
G
D000469:Alkaline Phosphatase / Q000032:analysis; D000974:Antibodies, Antinuclear / Q000378:metabolism; D000911:Antibodies, Monoclonal / Q000378:metabolism; D001219:Aspartate Aminotransferases / Q000032:analysis; D001653:Bile Ducts, Intrahepatic / Q000166:cytology / Q000378:metabolism; D018395:CA-19-9 Antigen / Q000378:metabolism*; D005260:Female; D019693:Hepatitis, Autoimmune / Q000188:drug therapy* / Q000378:metabolism*; D022781:Hepatocytes / Q000378:metabolism; D006801:Humans; D007074:Immunoglobulin G / Q000032:analysis; D007150:Immunohistochemistry; D008099:Liver / Q000166:cytology / Q000473:pathology; D008875:Middle Aged; D013256:Steroids / Q000627:therapeutic use*; D013997:Time Factors; D016896:Treatment Outcome
D000974:Antibodies, Antinuclear; D000911:Antibodies, Monoclonal; D018395:CA-19-9 Antigen; D007074:Immunoglobulin G; C440408:MIB-1 antibody; D013256:Steroids; D001219:Aspartate Aminotransferases; D000469:Alkaline Phosphatase