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

Douglas Lowe, Jeffrey Lee, Robert Schade, Ayaz Chaudhary

Research output: Contribution to journalArticlepeer-review

9 Scopus citations


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
Issue number3
StatePublished - Mar 1 2006


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

ASJC Scopus subject areas

  • Medicine(all)


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