Normalization of markedly elevated alpha-fetoprotein in a virologic nonresponder with HCV-related cirrhosis. -- Hepatitis C Outreach Project

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Subject: Normalization of markedly elevated alpha-fetoprotein in a virologic nonresponder with HCV-related cirrhosis.

Author:
Stein DF, Myaing M. ;Dig Dis Sci 2002 Dec;47(12):2686-90
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Date Posted: Wed, January 08 2003, 6:40:59 PST
In reply to: KS Gutfreund, VG Bain CMAJ 2000;162(6):827-33 's message, "Chronic viral hepatitis C: management update" on Wed, August 15 2001, 8:27:35 PDT

Dig Dis Sci 2002 Dec;47(12):2686-90

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

Stein DF, Myaing M.

Hepatology Division, Department of Gastroenterology, St. Barnabas Hospital, Weill Medical College of Cornell University, Bronx, New York, USA.

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.

PMID: 12498286 [PubMed - in process]

Hepatitis C Outreach Project

www.hcop.org

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Thyrotoxicosis induced by alpha-interferon therapy in chronic viral Wong V, et al; Clin Endocrinol (Oxf) 2002 Jun;56(6):793-8 Thu, July 31 2003, 7:50:57 PDT

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>Dig Dis Sci 2002 Dec;47(12):2686-90 > > >Normalization of markedly elevated alpha-fetoprotein >in a virologic nonresponder with HCV-related cirrhosis. > >Stein DF, Myaing M. > >Hepatology Division, Department of Gastroenterology, >St. Barnabas Hospital, Weill Medical College of >Cornell University, Bronx, New York, USA. > >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. > >PMID: 12498286 [PubMed - in process] > >Hepatitis C Outreach Project > >www.hcop.org

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