title: Markedly elevated alpha-fetoprotein levels without hepatocellular carcinoma.
abstract: Although low-grade elevations of AFP are associated with benign liver disease including acute and chronic hepatitis and cirrhosis, AFP values above 400 ng/mL are often used as a surrogate marker for HCC. The case of a 45-year-old Caucasian woman, who while receiving interferon therapy for HCV, was found to have a marked elevation of her serum AFP level, is reported. Her baseline AFP of 7.0 ng/mL increased progressively over three months to a peak value of 734.5 ng/mL. Initial imaging was normal. Three months later, a CT scan detected two focal lesions in the dome of the liver. A post-ethiodol hepatic CT scan revealed persistent uptake at this site but fluoroscopy-guided liver biopsy failed to identify a HCC. Normalization of her AFP level occurred while she continued to receive IFN for HCV. The patient has remained stable over more than three years of follow-up. While others have reported AFP elevations in cirrhotics with HCV without evidence of HCC, to our knowledge there are no reports of an individual receiving IFN treatment for hepatitis C with AFP levels that rose over several months in the absence of a HCC.
authors.affiliation: Division of Gastroenterology, Hepatology and Nutrition, Department of Medicine, Stritch School of Medicine, Loyola University Medical Center, Maywood, IL 60153-5500, USA.
authors.forename: Ahmad W
authors.initials: AW
authors.lastname: Cheema
authors.forename: Todd
authors.initials: T
authors.lastname: Hirschtritt
authors.forename: David H
authors.initials: DH
authors.lastname: Van Thiel
mesh_terms: D014408:Biomarkers, Tumor / Q000097:blood*; D001707:Biopsy, Needle; D006528:Carcinoma, Hepatocellular / Q000175:diagnosis / Q000473:pathology*; D003937:Diagnosis, Differential; D005260:Female; D005500:Follow-Up Studies; D019698:Hepatitis C, Chronic / Q000188:drug therapy / Q000473:pathology*; D006801:Humans; D007150:Immunohistochemistry; D016898:Interferon-alpha / Q000627:therapeutic use; D008111:Liver Function Tests; D008113:Liver Neoplasms / Q000175:diagnosis / Q000473:pathology*; D008875:Middle Aged; D012307:Risk Factors; D012680:Sensitivity and Specificity; D012720:Severity of Illness Index; D000509:alpha-Fetoproteins / Q000032:analysis / Q000378:metabolism*
chemical_list: D014408:Biomarkers, Tumor; D016898:Interferon-alpha; D000509:alpha-Fetoproteins