Acute exacerbation of hepatitis in liver cirrhosis with very high levels of alpha-fetoprotein but no occurrence of hepatocellular carcinoma

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Korean J Intern Med. 2005 Mar;20(1):80-5.

Acute exacerbation of hepatitis in liver cirrhosis with very high levels of

alpha-fetoprotein but no occurrence of hepatocellular carcinoma.

Bae JS, Park SJ, Park KB, Paik SY, Ryu JK, Choi CK, Hwang TJ.

Department of Gastroenterology, Boondang Jaeseng General Hospital, Sungnam,

Korea. hellojsb@...

Aminotransferase levels do not always increase during acute hepatitis or

during an acute flare-up of chronic hepatitis. Persistently increased levels

of serum alpha-Fetoprotein in an adult with liver disease suggest not only

the presence or progression of hepatocellular Carcinoma or its recurrence

after hepatic resection or after other therapeutic approaches such as

chemotherapy or chemoembolization, but also it suggests that there is an

acute exacerbation of hepatitis or liver cirrhosis. We report here on two

unusual cases of HBV- & HCV-related liver cirrhosis with acute exacerbation

of hepatitis in which there was an insignificant elevation of the

aminotransferase levels, but there were markedly increased alpha-Fetoprotein

levels observed. The levels of alpha-Fetoprotein decreased gradually in both

cases since the beginning of antiviral therapy, which implies that the

increased levels were due to aggravation of the accompanying hepatitis.

These cases also emphasize that using only the measurement of

alpha-Fetoprotein is not sufficient for the diagnosis of hepatocellular

carcinoma, and that this diagnosis also requires a more specific measurement

such as AFP L3 along with the standard imaging studies.

PMID: 15906959