Increased serum tumor markers in a patient with rheumatoid arthritis

Tumor-associated antigens are used to assess the response to treatment and follow-up of malignancies.they may be expressed by inflammatory cells, and play an important role in the adhesion and metastasis of malignant cells. increased level of tumor associated antigens were reported in patients with pleural effusion and pulmonary involvement of inflammatory rheumatic diseases.we aimed to present the relationship between tumor markers and disease activity in a female patient diagnosed with ra. 61-year-old female patients diagnosed with ra since one year was admitted to our clinic with the tenderness and swelling of her right knee, both wrists and metacarpophalangeal joints. she had no medical history, except for taking leflunomide 20 mg/day and sulfasalazine 2 g/day.physical examination revealed bilateral pulmonary crackles in the lower zone. the laboratory findings of the patients were as follows: disease activity score [das-28] was 6.02,erythrocyte sedimentation rate [esr]: 72 mm/h, crp: 37.95 mg/l, rheumatoid factor: 48.5 iu/ml, anti-ccp: 67, 1 u/ml, ca19-9: 410.67 u/ml [0-37/ml], ca-125: 197.1/ml [0-35/ml] and ca-15-3: 51,6/ml [0-31.3 u/ml]. increased reticular density was observed on bilateral middle and lower zone of anterior-posterior- chest x- ray and widespread reticular infiltrates, ground glass opacities and the honeycomb changes were seen on chest ct. there was no evidence with any malignancy and anti-inflammatory treatment was given for patient with active disease. on the follow-up, the level of esr, crp, das-28, ca19-9, ca15-3 and ca-125 were decreased. the ideal biomarkers are needed to determine of disease activity, organ injury and response to treatment in ra. since there is a correlation between increased tumor marker levels and organ involvement, these biomarkers may be helpful to assess disease progression and response to treatment in connective tissue diseases. tumor markers may be used for the evaluation of disease activity in ra patients (especially with lung involvement), after malignancies have been ruled out.