Uğur ÖNAL, MELTEM TAŞBAKAN, Oğuz Reşat SİPAHİ, MEHMET SEZAİ TAŞBAKAN, HÜSNÜ PULLUKÇU, CENGİZ ÇAVUŞOĞLU, Coşan TEREK, Sercan ULUSOY

TÜBERKÜLOZ PERİTONİT TANISI ALAN SERUM CA-125 DÜZEYİ YÜKSEK BEŞ OLGU SUNUMU

Tüberküloz peritonit, ekstrapulmoner tüberküloz formları arasında nadir görülen bir formdur. Tanı genellikle periton biyopsisinin patolojik incelemesi veya kültürde üreme olması ile koyulmaktadır. Bu yazıda tüberküloz peritonit tanısı alan serum CA-125 düzeyleri yüksek beş olgu sunulmaktadır. Yaşları sırası ile 63, 41, 25, 72 ve 73 olan beş kadın hasta kliniğimize üç aydan fazla süren karın ağrısı şikayeti ile başvurmuştur. Olguların hepsi malignansi araştırılan hastalar olup CA-125 düzeyleri biyopsi öncesinde yüksek saptanmıştır. Dört hastaya periton biyopsisi ve bir hastaya parasentez yapılmıştır. Beş hastanın üçüne ait örneklerde Ehrlich Ziehl Neelsen (EZN) boyaması, kültür ve polimeraz zincir reaksiyonu (PCR) test sonuçları negatif olarak saptanmış fakat klinik ve patolojik sonuçlar ile tüberküloz peritonit düşünülmüş ve tüberküloz tedavisi ile klinik olarak yanıt alınmıştır. Bir hastanın doku kültüründe ve diğer bir hastanın da PCR testi sonucunda Mycobacterium tuberculosis pozitifliği saptanmıştır. Yüksek CA-125 düzeyleri epitelyal over kanseri için bir tümör belirteci olarak kullanılmasına rağmen tüberküloz peritonit gibi inflamatuvar hastalıklarda da görülebilmektedir. Yüksek CA-125 değerleri görüldüğünde tüberküloz peritonit de dışlanmalıdır

Tuberculosis Peritonitis With High Serum CA-125 Levels: Five Case Reports

Peritoneal tuberculosis is an uncommon site of extrapulmonary infection. It is usually diagnosed after pathological examination or mycobacterial culture of peritoneal biopsy. In this paper, we present five patients with elevated serum CA-125 levels who were diagnosed with tuberculosis peritonitis. Five female patients (63, 41, 25, 72 and 73-year old) admitted to our clinic with the main complaint of abdominal pain for at least three months. All of them were investigated for malignancy and their CA-125 levels were high before the biopsy was considered. Peritoneal biopsies were performed to four patients and one patient had paracentesis. For peritoneal biopsies of three of the five patients; Ehrlich Ziehl Neelsen (EZN) stainings, mycobacterial cultures and polimerase chain reaction (PCR) tests were negative. However, clinical and pathological findings pointed us towards peritoneal tuberculosis and clinical improvement was seen after tuberculosis treatment. One of the patients’ biopsy tissue culture was positive and another’s PCR was positive for Mycobacterium tuberculosis. Although high CA-125 level is used as a tumor marker of epithelial ovarian cancer, it can be elevated because of inflamatory diseases such as tuberculous peritonitis. Tuberculous peritonitis should also be ruled out when high levels of CA-125 were seen

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