title: Extremely elevated CA19-9 in acute cholangitis.
abstract: A 68-year-old women was admitted with the chief complaints of epigastralgia with radiation to the back and jaundice. Fever and chills were also noted. The laboratory data showed alkaline phosphatase, 245 U/L (normal range: 28-94); Direct Bilirubin, 5.29 mg% (0-0.4); Total Bilirubin, 8.4 mg% (0.2-1.4). Surprisingly, the serum CA19-9 was 5673.8 U/ml (normal value: <37). Abdominal sonography showed dilated common hepatic duct. MRCP demonstrated diffuse biliary tree dilatation with a very low signal intensity in distal common bile duct. Surgical intervention reveled a black stone at distal common bile duct and was successfully retrieved. After operation, the CA19-9 fell to 63.1 u/ml two weeks later and returned to normal (10.4 U/ml) one month later.
authors.affiliation: Department of Surgery, Chang Gung Memorial Hospital, Kaohsiung, 123, Ta-Pei Road, Niao-Sung Hsiang, Kaohsiung Hsien, Taiwan. smsheen@yahoo.com
authors.forename: Shyr-Ming
authors.initials: SM
authors.lastname: Sheen-Chen
authors.forename: Cheuk-Kwan
authors.initials: CK
authors.lastname: Sun
authors.forename: Yei-Wei
authors.initials: YW
authors.lastname: Liu
authors.forename: Hock-Liew
authors.initials: HL
authors.lastname: Eng
authors.forename: Sheung-Fat
authors.initials: SF
authors.lastname: Ko
authors.forename: Chung-Huang
authors.initials: CH
authors.lastname: Kuo
mesh_terms: D000208:Acute Disease; D000368:Aged; D015415:Biomarkers / Q000097:blood; D018395:CA-19-9 Antigen / Q000097:blood*; D049448:Cholangiopancreatography, Magnetic Resonance; D002761:Cholangitis / Q000097:blood* / Q000175:diagnosis / Q000209:etiology; D002763:Cholecystectomy; D003937:Diagnosis, Differential; D005260:Female; D042882:Gallstones / Q000097:blood / Q000150:complications / Q000601:surgery; D006801:Humans; D012720:Severity of Illness Index
chemical_list: D015415:Biomarkers; D018395:CA-19-9 Antigen