Tuberc Respir Dis.  2013 Sep;75(3):125-127.

Extremely Increased Serum Carbohydrate Antigen 19-9 Levels Caused by New or Resistant Infections to Previous Antibiotics in Chronic Lung Diseases

• Shin JY
• Yoo SJ
• Park BM
• Jung SS
• Kim JO
• Lee JE

Abstract

In this paper, we describe 72-year-old female patient without evidence of malignant disease presented with significantly elevated serum carbohydrate antigen (CA) 19-9 levels by respiratory infections. She was diagnosed with respiratory infections due to Mycobacterium avium complex and Pseudomonas aeruginosa. The serum CA 19-9 levels remarkably increased (1,453-5,300 U/mL; reference range, <37 U/mL) by respiratory infection and abruptly decreased (357-534 U/mL) whenever infection was controlled by specific treatments. This case suggests that serum CA 19-9 levels may be used as a diagnostic marker to indicate new or resistant infections to previous antibiotics in chronic lung diseases without significant changes in chest X-ray findings.

Keyword

CA19-9 Antigen; Infection; Lung Neoplasms

MeSH Terms

Aged
Anti-Bacterial Agents
Female
Humans
Lung
Lung Diseases
Lung Neoplasms
Mycobacterium avium Complex
Pseudomonas aeruginosa
Reference Values
Respiratory Tract Infections
Thorax
Anti-Bacterial Agents

Figure

• 

  Figure 1 Summary from the initial visit to the recent follow-up. (A-F) Chest radiograph showed no significant interval changes. (G-J) Chest computed tomography (CT) findings. (H) In May 2010, Chest CT revealed nodularities on both lower lung fields. (I) In October 2010, chest CT revealed decreased nodularities. (J) In June 2012, chest CT revealed aggravated bilateral nodularities. CA 19-9, carbohydrate antigen 19-9.

• 

  Figure 2 Serum carbohydrate antigen 19-9 (CA 19-9) levels (U/mL). MAC, Mycobacterium avium complex.

Reference

1. Plebani M, Basso D, Panozzo MP, Fogar P, Del Favero G, Naccarato R. Tumor markers in the diagnosis, monitoring and therapy of pancreatic cancer: state of the art. Int J Biol Markers. 1995; 10:189–199.

2. Yokoyama T, Ikedou Y, Kido F, Tanoue S, Tashiro K, Ninomiya H, et al. A study of sialylated carbohydrate antigen in patients with benign bronchopulmonary disease. Nihon Kokyuki Gakkai Zasshi. 1998; 36:851–856.

3. Matsuoka Y, Endo K, Kawamura Y, Yoshida T, Saga T, Watanabe Y, et al. Normal bronchial mucus contains high levels of cancer-associated antigens, CA125, CA19-9, and carcinoembryonic antigen. Cancer. 1990; 65:506–510.

4. Shimizu Y, Hamada T, Tanaka Y, Sasaki A, Nemoto T. Colocalization of CA19-9 and KL-6 to epithelial cells in dilated bronchioles in a patient with idiopathic pulmonary fibrosis complicated by diffuse alveolar damage. Respirology. 2002; 7:281–284.

5. Mukae H, Hirota M, Kohno S, Komori K, Fukushima K, Hiratani K, et al. Elevation of tumor-associated carbohydrate antigens in patients with diffuse panbronchiolitis. Am Rev Respir Dis. 1993; 148:744–751.

6. Kim HR, Lee CH, Kim YW, Han SK, Shim YS, Yim JJ. Increased CA 19-9 level in patients without malignant disease. Clin Chem Lab Med. 2009; 47:750–754.

7. Yamazaki Y, Kubo K, Takamizawa A, Yamamoto H, Honda T, Sone S. Markers indicating deterioration of pulmonary Mycobacterium avium-intracellulare infection. Am J Respir Crit Care Med. 1999; 160:1851–1855.

8. Watanabe K, Fujimura M, Kasahara K, Yasui M, Myou S, Watanabe A, et al. Characteristics of pulmonary Mycobacterium avium-intracellulare complex (MAC) infection in comparison with those of tuberculosis. Respir Med. 2003; 97:654–659.

9. Kodama T, Satoh H, Ishikawa H, Ohtsuka M. Serum levels of CA19-9 in patients with nonmalignant respiratory diseases. J Clin Lab Anal. 2007; 21:103–106.

10. Sheen-Chen SM, Sun CK, Liu YW, Eng HL, Ko SF, Kuo CH. Extremely elevated CA19-9 in acute cholangitis. Dig Dis Sci. 2007; 52:3140–3142.

11. Lin CL, Changchien CS, Chen YS. Mirizzi's syndrome with a high CA19-9 level mimicking cholangiocarcinoma. Am J Gastroenterol. 1997; 92:2309–2310.