Elevated CEA levels in sera in patients with allergic bronchopulmonary aspergillosis (ABPA)

Hirotaka Matsuzaki, Wakae Tanaka, Yasuhiro Kojima, Masaki Kawakami, Masaru Suzuki, Yoshio Sakamoto , Tadashi Horiuchi

Author address: 

Respiratory Medicine, Kanto Central Hospital, Tokyo, Japan; 2Internal Medicine, Okutama Hospital, Tokyo, Japan

Abstract: 

Background: ABPA is an allergic disease associated with peripheral blood eosinophilia and elevated total IgE in serum. It sometimes accompanies with bronchiectasis filled with mucus plug detected by chest X-ray- or CT films or fiberotic bronchoscopy.Mucus plug is not infrequently misdiagnosed as lung tumor. Carcinoembryonic antigen (CEA) is one of tumor markers and measured as a diagnostic as well as surrogate marker of bronchogenic carcinoma. It has been reported that some patients with ABPA demonstrated elevated CEA levels in their sera. Aim: To evaluate clinical significance of serum CEA level in patients with ABPA. Methods: Ten patients (6 women), aged from 39 to 78 (median; 67) with ABPA were evaluated. All patients were never smokers or ex-smokers. Serum CEA level, eosinophil number, total IgE, Aspergillus fumigatus (Af )-specific IgE- and precipitating antibodies were measured. Chest roentgenogram and or CT were examined when blood test was performed. For comparison, serum CEA levels were also evaluated in patients with bronchiectasis (n = 20). Results: Among 10 patients with ABPA, five demonstrated elevated serum CEA levels (6.2 - 140.0 ng/ml; normal range 8804; 5 ng/ml). Massive mucus plugs were demonstrated in four out of five patients on chest CT or X-ray films. Two out of five patients were treated with systemic glycocorticosteroids resulting in the decrease in CEA levels. Another patient showed the decrease in CEA spontaneously in parallel with the decrease in eosinophil number. Conclusion: Massive mucus plug may induce
2011

abstract No: 

P473

Full conference title: 

European Respiratory Congress
    • ERS 21st (2011)