It is reasonable to rule out assay interference given the history and normal examination so far. It would have been helpful if you had run a dilution series and a PEG precipitation of immunoglobulins and re-measured CA125 on supernatant to rule out/in antibody interference.
Best regards
Mohammad
-----Original Message-----
From: Clinical biochemistry discussion list [mailto:[log in to unmask]] On Behalf Of Rebecca Beresford-Green
Sent: 17 February 2017 11:33
To: [log in to unmask]
Subject: Extremely high CA125
Dear Mailbase,
We have a case of extremely high CA125 in a young woman who shows no evidence of gynaecological pathology following investigation.
The lady presented to A&E in early December with acute abdominal pain lasting a few hours on and off over two days associated with anorexia and nausea. The GP ordered a CA125 ~6 weeks later which we reported as 8681 kU/L. A repeat two weeks later gave a similar result (9033 kU/L). Investigations have shown retroverted uterus of normal size and no evidence of endometriosis or excess free fluid. Ovaries appear normal. Para-aortic lymphadenopathy was identified but this has been investigated by the haematologist who is not concerned. AFP 5 HGG 2. She has a history of post-partum HELLP and PPH
We (and her clinician) are suspecting an assay interference (?HAMA) and will send her next sample to another lab for analysis with another method (we are using Cobas c602), although she is not due bloods for another couple of months. However I wonder whether the collective brain has any other suggestions for the cause of this high CA125 or other investigations we could do?
Best wishes,
Rebecca Beresford-Green
Clinical Scientist
Biochemistry
Northampton General Hospital
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