Marked ascites and serum carbohydrate antigen (CA) 125 elevation in a patient with anorexia nervosa

We report a 28-year-old woman with a 4-year history of anorexia nervosa who abruptly developed massive ascites and moderate pedal edema associated with marked elevation of carbohydrate antigen (CA) 125, a serum tumor marker. She gained 8 kg over 2 weeks after having maintained a body mass index (BMI) of 12.2 kg/m 2 . The upper body was none-dematous, appearing dehydrated. The serum CA125 concentration was 688 U/ml (normal, <35 U/ml). These findings initially suggested malignant disease within the abdominal cavity, particularly ovarian carcinoma. However, none was found and ascites disappeared completely with medical treatment alone. Her CA125 level normalized in parallel with the decrease in ascites. Marked ascites with an elevated CA125 level thus can result from anorexia nervosa.