Transient increase of CA 19–9 serum concentrations in a liver transplant recipient with cystic fibrosis and hepatic abscess: a case report and brief literature review

Denis, Jérôme Alexandre; Mazzola, Alessandra; Nguyen, Guillaume; Brochet, Christine; Larsen, Annette K.; Conti, Filoména

doi:10.1016/j.clinbiochem.2018.10.009

Cited by 6 publications

(6 citation statements)

References 16 publications

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“…However, the diagnostic sensitivity and positive predictive value of CA19-9 for cancers is low [ 3 ]. The elevation of CA 19 − 9 is also found in several non-malignant diseases, including diabetes [ 7 , 8 , 12 ].…”

Section: Discussionmentioning

confidence: 99%

Effect of glycotoxicity and lipotoxicity on carbohydrate antigen 19 − 9 in the patients with diabetes

Liu,

Wang

2024

BMC Endocr Disord

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Objectives In comparison to the subjects without diabetes, a greater concentration of serum carbohydrate antigen 19 − 9 (CA 19 − 9) was observed in the subjects with diabetes. Nevertheless, since the occurrence of abnormal CA 19 − 9 is not widespread among the whole diabetic population, this phenomenon has not attracted enough attention. The prevalence of abnormal CA 19 − 9 in hospitalized patients with diabetes was the focus of our research. Method A total of 385 subjects with diabetes and 200 controls were enrolled and all had been tested the CA19-9 levels. Cases of cancers were excluded through examination and followup for 1 year. Results We found that the rate of patients with abnormal CA19-9 level was 8.3%. The rate of patients with abnormal CA19-9 level was 14.0% in the HbA1c ≥ 9% group, and 3.0% in the HbA1c < 9% group, 2.5% in the control group. There was no significant difference in the HbA1c < 9% group and the control group. A significant correlation between serum CA19-9 and both HbA1c and total cholesterol was observed, yet no difference in CRP level was observed between subjects with normal CA19-9 level and subjects with abnormal CA19-9 level. However, a significant difference in fasting C-peptide levels was observed between the two groups, p = 0.039. Conclusion The percentage of patients with diabetes exhibiting elevated CA19-9 level is 14% in the HbA1c ≥ 9% diabetic patients, much higher than expected. The underlying mechanism may be related to islet injury caused by glycotoxicity and lipotoxicity. Strengths and limitations of the study We studied the rate of hospitalized diabetic patients with elevated CA 19 − 9 which were characterized with poorly controlled blood glucose. We found that the elevation of CA 19 − 9 was unexpectedly high in diabetic inpatients without development to cancer. The limitation of this study is that the underlying mechanism is not sufficiently studied.

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Section: Discussionmentioning

confidence: 99%

Effect of glycotoxicity and lipotoxicity on carbohydrate antigen 19 − 9 in the patients with diabetes

Liu,

Wang

2024

BMC Endocr Disord

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“…Despite the high incidence of pulmonary P. aeruginosa colonisation,33 few case reports exist for liver abscesses or biliary tree infections in patients with CF 34 35. Liver abscesses are more commonly reported secondary to choledochoduodenostomy, an operation this patient underwent in 1989.…”

Section: Discussionmentioning

confidence: 99%

Delayed identification of compound heterozygous (Phe508del/Arg117His) cystic fibrosis variants in a patient awaiting liver transplantation

Hu,

McLellan,

Grogono

et al. 2023

BMJ Case Rep

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A man in his 60s undergoing liver transplant assessment was referred to the respiratory team after a thoracic CT scan revealed diffuse tree-in-bud changes. He had a history of infertility, chronic pancreatitis and liver cirrhosis with portal hypertension. Broncho-alveolar lavage was positive forPseudomonas aeruginosa. Genetic screening found two cystic fibrosis transmembrane conductance regulator variants: Phe508del and Arg117His-7T. The patient was referred to the regional cystic fibrosis (CF) centre for follow-up but died from hepatobiliary complications. The atypical presentation with relatively late onset of pulmonary disease and hepatobiliary disease predominance created a diagnostic challenge. This case is a reminder that while CF is a monogenic disorder, its manifestation, natural history and extent can be highly variable. Taking a thorough medical history of any chronic illness is essential, and patients with the appropriate clinical presentation, regardless of age, should be investigated for CF.

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“…CA-19-9 has a 20% false-positive rate as a screening test and the serum level may also be elevated with other conditions, including an increased production of sputum, diabetes, chronic kidney failure, and infections. For these reasons, an elevated CA-19-9 Level alone may not be enough to justify additional expensive and unnecessary investigations[ 56 ]. The false-positivity rate, financial burden of testing, and unknown age to begin the screening has made the surveillance for pancreaticobiliary malignancies more difficult in the CF population.…”

Section: Rationale For Screening Of Gi and Hepatopancreatobiliary Cancersmentioning

confidence: 99%

Screening strategy for gastrointestinal and hepatopancreatobiliary cancers in cystic fibrosis

Hoskins

Wasuwanich

Scheimann

et al. 2021

WJGO

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Based on systematic review and meta-analysis, the risk for developing cancers in patients with cystic fibrosis (CF) is known to be significantly greater than in the general population, including site-specific cancers of the esophagus, small bowel, colon, liver, biliary tract, and pancreas. An even higher risk has been found in patients who have severe CF transmembrane conductance regulator ( CFTR ) genotypes or who have undergone organ transplantation and are immunosuppressed. The risk continues to rise as life expectancies steadily climb due to advancements in medical care and treatment for CF. The colorectal cancer risk is at such a high level that CF has now been declared a hereditary colon cancer syndrome by the Cystic Fibrosis Foundation. The CFTR gene has been strongly-associated with the development of gastrointestinal (GI) cancers and mortality in the CF population. Even CF carriers have shown an increased rate of GI cancers compared to the general population. Several limitations exist with the reported guidelines for screening of GI and hepatopancreatobiliary cancers in the CF population, which are largely universal and are still emerging. There is a need for more precise screening based on specific risk factors, including CFTR mutation, medical co-morbidities (such as gastroesophageal reflux disease, distal intestinal obstruction syndrome, and diabetes mellitus), familial risks for each cancer, gender, age, and other factors. In this review, we propose changes to the guidelines for GI screening of patients with CF. With the development of CFTR modulators, additional studies are necessary to elucidate if there is an effect on cancer risk.

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Transient increase of CA 19–9 serum concentrations in a liver transplant recipient with cystic fibrosis and hepatic abscess: a case report and brief literature review

Cited by 6 publications

References 16 publications

Effect of glycotoxicity and lipotoxicity on carbohydrate antigen 19 − 9 in the patients with diabetes

Effect of glycotoxicity and lipotoxicity on carbohydrate antigen 19 − 9 in the patients with diabetes

Delayed identification of compound heterozygous (Phe508del/Arg117His) cystic fibrosis variants in a patient awaiting liver transplantation

Screening strategy for gastrointestinal and hepatopancreatobiliary cancers in cystic fibrosis

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