Alpha-1-antitrypsin deficiency resulting in a hitherto unseen presentation of hepatocellular carcinoma: polycythemia but with normal alpha fetoprotein.
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.
Owen
David Ryan
DR
Department of Geriatric Medicine, Area Q111, Queen Elizabeth II Hospital, Howlands, Welwyn Garden City, Hertfordshire, AL7 4HQ, United Kingdom. david.owen@nhs.net
Sivakumar
Ramachandran
R
Suh
Eui-Sik
ES
Seevaratnam
Murugiah
M
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*
C043392:SERPINA1 protein, human; D000515:alpha 1-Antitrypsin; D000509:alpha-Fetoproteins