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Both patients exhibited cholestatic liver enzyme elevations, and neither had structural abnormalities in the pancreaticobiliary system. In both cases, CA19-9 levels normalized following appropriate antibiotic treatment for syphilis. These cases suggest that systemic inflammation, hepatocellular injury with regenerative changes, and epithelial damage associated with syphilitic hepatitis may contribute to transient CA19-9 elevation.<\/jats:p>","DOI":"10.1177\/09564624251348680","type":"journal-article","created":{"date-parts":[[2025,6,7]],"date-time":"2025-06-07T12:24:21Z","timestamp":1749299061000},"page":"744-746","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Secondary syphilis presenting with elevated CA19-9: A report of two cases"],"prefix":"10.1177","volume":"36","author":[{"given":"Toshiya","family":"Nakashima","sequence":"first","affiliation":[{"name":"Division of General Internal Medicine, Department of Internal Medicine, Tokyo Medical University Ibaraki Medical Center, Inashiki District, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9857-8614","authenticated-orcid":false,"given":"Hiroshi","family":"Ito","sequence":"additional","affiliation":[{"name":"Division of General Internal Medicine, Department of Internal Medicine, Tokyo Medical University Ibaraki Medical Center, Inashiki District, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7376-0113","authenticated-orcid":false,"given":"Koki","family":"Kikuchi","sequence":"additional","affiliation":[{"name":"Department of Infectious Diseases, Teine Keijinkai Hospital, Sapporo, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[2025,6,7]]},"reference":[{"key":"e_1_3_4_2_2","doi-asserted-by":"publisher","DOI":"10.3390\/jcm13061603"},{"key":"e_1_3_4_3_2","doi-asserted-by":"publisher","DOI":"10.12998\/wjcc.v12.i3.650"},{"key":"e_1_3_4_4_2","doi-asserted-by":"publisher","DOI":"10.1002\/ccr3.3229"},{"key":"e_1_3_4_5_2","doi-asserted-by":"publisher","DOI":"10.2147\/CCID.S315235"},{"issue":"2","key":"e_1_3_4_6_2","first-page":"105","article-title":"The clinical utility of serum CA 19-9 in the diagnosis, prognosis and management of pancreatic adenocarcinoma: an evidence based appraisal","volume":"3","author":"Ballehaninna UK","year":"2012","unstructured":"Ballehaninna UK, Chamberlain RS. 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