title: Alpha-1-antitrypsin deficiency resulting in a hitherto unseen presentation of hepatocellular carcinoma: polycythemia but with normal alpha fetoprotein.
abstract: Polycythemia is a known paraneoplastic manifestation of hepatoma, but only in the presence of alpha-fetopro (AFP). We present a case of polycythemia in the absence of AFP, and suggest concurrent alpha-1-antitrypsin deficiency as the cause for breaking this rule. We also suggest a reason for the apparent constant conjunction between polycythemia and AFP in hepatoma.
authors.affiliation: Department of Geriatric Medicine, Area Q111, Queen Elizabeth II Hospital, Howlands, Welwyn Garden City, Hertfordshire, AL7 4HQ, United Kingdom. david.owen@nhs.net
authors.forename: David Ryan
authors.initials: DR
authors.lastname: Owen
authors.forename: Ramachandran
authors.initials: R
authors.lastname: Sivakumar
authors.forename: Eui-Sik
authors.initials: ES
authors.lastname: Suh
authors.forename: Murugiah
authors.initials: M
authors.lastname: Seevaratnam
mesh_terms: D000368:Aged; D006528:Carcinoma, Hepatocellular / Q000175:diagnosis / Q000209:etiology / Q000378:metabolism*; D006801:Humans; D008113:Liver Neoplasms / Q000175:diagnosis / Q000209:etiology / Q000378:metabolism*; D008297:Male; D011086:Polycythemia / Q000209:etiology*; D000515:alpha 1-Antitrypsin / Q000378:metabolism*; D019896:alpha 1-Antitrypsin Deficiency / Q000378:metabolism*; D000509:alpha-Fetoproteins / Q000378:metabolism*
chemical_list: C043392:SERPINA1 protein, human; D000515:alpha 1-Antitrypsin; D000509:alpha-Fetoproteins