Normalization of markedly elevated alpha-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 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.
Stein
David F
DF
Hepatology Division, Department of Gastroenterology, St. Barnabas Hospital, Weill Medical College of Cornell University, Bronx, New York, USA.
Myaing
Malay
M
D000410:Alanine Transaminase / Q000097:blood; D000998:Antiviral Agents / Q000627:therapeutic use; D001219:Aspartate Aminotransferases / Q000097:blood; D019698:Hepatitis C, Chronic / Q000097:blood* / Q000188:drug therapy; D006801:Humans; D000077190:Interferon alpha-2; D016898:Interferon-alpha / Q000627:therapeutic use; D008297:Male; D008875:Middle Aged; D011994:Recombinant Proteins; D012254:Ribavirin / Q000627:therapeutic use; D017211:Treatment Failure; D000509:alpha-Fetoproteins / Q000032:analysis*
D000998:Antiviral Agents; D000077190:Interferon alpha-2; D016898:Interferon-alpha; D011994:Recombinant Proteins; D000509:alpha-Fetoproteins; D012254:Ribavirin; D001219:Aspartate Aminotransferases; D000410:Alanine Transaminase