Elevated serum CA 125 concentration in patients with tuberculous peritonitis: a case-control study

Abstract

Objectives: High serum cancer antigen (CA) 125 levels have been shown to be present in patients with ovarian carcinoma, nongynecological cancers, and some benign diseases and have been used as a useful marker for monitoring patients with epithelial ovarian cancer. Although tuberculous peritonitis with elevated serum CA 125 levels is an important diagnostic problem because it may lead to misdiagnosis as ovarian carcinoma and unnecessary laparatomies, the levels of CA 125 in patients with tuberculous peritonitis has not been studied in detail.

Methods: Serum CA 125 levels in 11 consecutive patients (2 males, 9 females) with tuberculous peritonitis admitted to Hacettepe University and 20 healthy adult controls (7 males, 13 females) were studied.

Results: Serum CA 125 levels were found to be elevated in all patients with tuberculous peritonitis. The mean level in the study group was 316.6 IU/ml, whereas the level was 13.8 IU/ml in the control group (p < 0.0001). Serum CA 125 normalization showed a very close correlation with the response to antituberculous therapy.

Conclusions: Tuberculous peritonitis must be considered in a differential diagnosis of patients with elevated serum CA 125 concentration. Correct diagnosis may prevent unnecessary laparatomies performed under the assumption of ovarian carcinoma, because it is cured completely by antituberculous therapy. Serum CA 125 level might be used as an effective marker in the diagnosis and follow-up of patients with tuberculous peritonitis.