Wu Jia-Feng, Li Hwa-Jung, Lee Ping-Ing, Ni Yen-Hsuan, Yu Sen-Chang, Chang Mei-Hwei
Department of Paediatrics, National Taiwan University Hospital, No. 7 Chung-Shan S. Road, Taipei, Taiwan.
Eur J Pediatr. 2003 Dec;162(12):853-5. doi: 10.1007/s00431-003-1319-3. Epub 2003 Oct 8.
A 13-year-old girl presented with non-specific symptoms of peritonitis, low grade fever and missed her normal menses. Computed tomography of her abdomen and pelvic cavity showed omental cake and a generalised thickened peritoneum. An elevated serum cancer antigen-125 (CA-125) level of 1248.5 U/ml was also noted and a diagnosis of peritonitis carcinomatosis was first suspected. Diagnostic laparoscopy revealed multiple tubercles over the whole peritoneum and the pathology report described granulomatous nodules with giant cells and epithelioid cells. Culture of the ascitic fluid revealed Mycobacterium tuberculosiswhich resulted in a final diagnosis of tuberculous peritonitis. The patient's fever and abdominal distension gradually subsided after anti-tuberculosis treatment. The serum CA-125 level also decreased significantly to 10.2 U/ml after treatment.
cancer antigen-125 levels may serve as a potential follow-up marker of disease activity and treatment response in tuberculous peritonitis.
一名13岁女孩出现腹膜炎的非特异性症状、低热且月经未正常来潮。其腹部和盆腔的计算机断层扫描显示有网膜饼和弥漫性增厚的腹膜。还注意到血清癌抗原125(CA - 125)水平升高至1248.5 U/ml,最初怀疑为癌性腹膜炎。诊断性腹腔镜检查发现整个腹膜有多个结节,病理报告描述为有巨细胞和上皮样细胞的肉芽肿性结节。腹水培养发现结核分枝杆菌,最终诊断为结核性腹膜炎。抗结核治疗后,患者的发热和腹胀逐渐消退。治疗后血清CA - 125水平也显著下降至10.2 U/ml。
癌抗原125水平可作为结核性腹膜炎疾病活动度和治疗反应的潜在随访标志物。