Normalization of markedly elevated α-fetoprotein in a virologic nonresponder with HCV-related cirrhosis

Measurement of serum AFP can be useful in the diagnosis of hepatocellular carcinoma (HCC). AFP is a fetal protein that is not normally present in the serum of adults but is elevated in most patients with HCC. The diagnosis of HCC is generally made in patients with a mass lesion in a cirrhotic liver...

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Bibliographic Details
Published in:	Digestive diseases and sciences Vol. 47; no. 12; pp. 2686 - 2690
Main Authors:	STEIN, David F, MYAING, Malay
Format:	Journal Article
Language:	English
Published:	Heidelberg Springer 01-12-2002
Subjects:	Alanine Transaminase - blood alpha-Fetoproteins - analysis Antiviral Agents - therapeutic use Aspartate Aminotransferases - blood Biological and medical sciences Hepatitis C, Chronic - blood Hepatitis C, Chronic - drug therapy Human viral diseases Humans Infectious diseases Interferon alpha-2 Interferon-alpha - therapeutic use Male Medical sciences Middle Aged Recombinant Proteins Ribavirin - therapeutic use Treatment Failure Viral diseases Viral hepatitis Human hepatitis C Standardization Biological marker Hepatic disease Non response Biology α-Fetoprotein interferon Virology Infection Case study Pathology Cirrhosis Chronic Histopathology Treatment Viral disease Digestive diseases Complication Viral hepatitis C
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Summary:	Measurement of serum AFP can be useful in the diagnosis of hepatocellular carcinoma (HCC). AFP is a fetal protein that is not normally present in the serum of adults but is elevated in most patients with HCC. The diagnosis of HCC is generally made in patients with a mass lesion in a cirrhotic liver if the AFP is over 400 ng/ml. Unfortunately, AFP is elevated in other conditions such as nonseminomatous germ cell tumor, chronic hepatitis, cirrhosis, pregnancy, and hepatic metastasis. A high AFP cutoff value for HCC would increase the specificity of the test, but would decrease the sensitivity considerably. We report the case of a patient with HCV and cirrhosis with a markedly elevated AFP of 1257 ng/ml in whom no evidence of HCC could be found after a thorough radiologic and histologic evaluation. Despite a virologic nonresponse to IFN-alpha2b and ribavirin therapy, there was a complete normalization of AFP.
Bibliography:	ObjectType-Case Study-2 SourceType-Scholarly Journals-1 ObjectType-Feature-4 content type line 23 ObjectType-Report-1 ObjectType-Article-3
ISSN:	0163-2116 1573-2568
DOI:	10.1023/A:1021044803279