Annals of clinical and laboratory science · 2025
Concurrent Elevation of CEA and CA 19-9 in a Patient with Allergic Bronchopulmonary Aspergillosis: A Case Report and Literature Review.
СтатьяКлинический случайОбзорНазвание и аннотация: Перевод в очереди
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Li Changxiao, Zheng Fangyuan, Jiao Mingzhi, Qi Mei, Lv Jiling
Аннотация
OBJECTIVE: Serum carbohydrate antigen (CA 19-9) and carcinoembryonic antigen (CEA) are common tumor markers that are mainly used in the diagnosis and therapeutic evaluation of malignant tumors. Here, we detail a case of allergic bronchopulmonary aspergillosis (ABPA) presenting with elevation of CEA and CA 19-9 levels.
CASE REPORT: A 22-year-old non-asthmatic male presented with recurrent cough, white mucopurulent sputum, and elevated serum CEA (20.55 ng/mL) and CA 19-9 (>1000 U/mL) levels. Investigations revealed Aspergillus-positive sputum culture, central bronchiectasis, mucus plugs on CT, eosinophilia, and migratory pulmonary lesions. Initial voriconazole therapy failed to prevent relapses. ABPA diagnosis was confirmed after re-evaluation. Combined voriconazole and methylprednisolone treatment achieved sustained remission over three years with normalization of tumor markers.
RESULTS: Elevation of CEA and CA 19-9 levels correlated with ABPA disease activity but not IgE/eosinophil levels. Post-treatment normalization of CEA and CA 19-9 levels supports their utility as inflammatory biomarkers. This case expands the ABPA phenotype and cautions against misinterpreting tumor markers as malignancy indicators in benign inflammatory contexts.
CONCLUSION: ABPA should be considered in non-asthmatic patients with recurrent respiratory symptoms and elevated tumor markers. Serial monitoring of CEA/CA 19-9 may aid therapeutic assessment.
CASE REPORT: A 22-year-old non-asthmatic male presented with recurrent cough, white mucopurulent sputum, and elevated serum CEA (20.55 ng/mL) and CA 19-9 (>1000 U/mL) levels. Investigations revealed Aspergillus-positive sputum culture, central bronchiectasis, mucus plugs on CT, eosinophilia, and migratory pulmonary lesions. Initial voriconazole therapy failed to prevent relapses. ABPA diagnosis was confirmed after re-evaluation. Combined voriconazole and methylprednisolone treatment achieved sustained remission over three years with normalization of tumor markers.
RESULTS: Elevation of CEA and CA 19-9 levels correlated with ABPA disease activity but not IgE/eosinophil levels. Post-treatment normalization of CEA and CA 19-9 levels supports their utility as inflammatory biomarkers. This case expands the ABPA phenotype and cautions against misinterpreting tumor markers as malignancy indicators in benign inflammatory contexts.
CONCLUSION: ABPA should be considered in non-asthmatic patients with recurrent respiratory symptoms and elevated tumor markers. Serial monitoring of CEA/CA 19-9 may aid therapeutic assessment.