Elevated CA-125 in IgG4 mesenteritis: a red herring or a disease biomarker? Case report and literature review
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Mesenteric panniculitis (MP) is a rare chronic disease characterized by inflammation and subsequently fibrosis of adipose tissue of the omentum. Only recently it has been associated with IgG4-related disease. Cancer antigen 125 (CA-125) is a high-molecular mass glycoprotein, traditionally associated with ovarian cancer, although it can be elevated in other conditions. Herein we describe a case of a 56-year-old man with IgG4 related mesenteric panniculitis associated with very high levels of CA-125 at the onset of disease. The CA-125 levels corresponded to clinical disease activity and improved with steroid therapy and rituximab. A literature review was performed concerning possible association of MP, IgG4-related disease and CA-125. The review of literature suggests that high levels of CA-125 can be raised in non-malignant, inflammatory conditions including IgG4-related mesenteritis and can improve with treatment.
KeywordsPanniculitis, peritoneal CA-125 antigen Mesentery Peritoneum Inflammation Immunoglobulin G Biomarkers, tumor
The authors thank Aristi Kourri (radiologist) for providing the images.
SP and GN were directly involved in the care of the patient. SP and EN conceived the idea to write the specific case as a case report and literature review. MMM and IP designed and executed the literature search, and drafted the first version of the manuscript with guidance from EN and SP. All authors discussed the results and commented on the manuscript.
No specific funding was received from any bodies in the public, commercial or not-for-profit sectors to carry out the work described in this manuscript.
Compliance with ethical standards
Conflict of interest
The authors have declared no conflicts of interest.
The patient consented to publication of his case.
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