Extremely elevated alpha-fetoprotein due to acute exacerbation of chronic hepatitis B without malignancy: A case report

被引：2

作者：

Yoon Y.-M. ^{[1
]}

Kang D.-Y. ^{[1
]}

Kim D.-Y. ^{[1
]}

Seo J.-W. ^{[2
]}

Lim H.-J. ^{[2
]}

Lee H.-J. ^{[3
]}

Park S.-G. ^{[3
]}

机构：

[1] Department of Internal Medicine, Chosun University Hospital, 365 Pilmun-daero, Dong-gu, Gwangju

[2] Department of Medicine, Graduate School, Chosun University, 309 Pilmun-daero, Dong-gu, Gwangju

[3] Department of Internal Medicine, Hemato-oncology, Chosun University Hospital, 365 Pilmun-daero, Dong-gu, Gwangju

来源：

Journal of Medical Case Reports | / 10卷 / 1期

关键词：

Hepatitis B; Hepatocellular carcinoma; Testicular cancer; Tumor markers; α-Fetoprotein;

D O I：

10.1186/s13256-016-0915-6

中图分类号：

学科分类号：

摘要：

Background: Alpha-fetoprotein is produced by a variety of tumors such as hepatocellular carcinoma, hepatoblastoma, and germ cell tumors of the ovary and testes. However, we present a case of significantly elevated serum alpha-fetoprotein without evidence of malignant disease in a patient who is a carrier of chronic hepatitis B. Case presentation: A 60-year-old Korean man presented with markedly increased alpha-fetoprotein (2350 ng/mL; normal <5 ng/mL). Various diagnostic evaluations, including computed tomography of the abdomen and thorax and ultrasonography of the abdomen and testes, showed liver cirrhosis and mild splenomegaly; however, no mass was detected in the liver, testes, or other organs scanned. The laboratory findings showed elevated liver function, positivity for hepatitis B e antigen, and a marked increase in hepatitis B virus deoxyribonucleic acid copy number (>7 × 105 IU/mL). Our patient was diagnosed with acute exacerbation of chronic hepatitis B, and we presumed that this condition might be related to extremely elevated alpha-fetoprotein. When our patient was treated with entecavir, the serum alpha-fetoprotein level immediately decreased, in parallel with the hepatitis B virus deoxyribonucleic acid copy number. Conclusions: We report a rare case of extremely elevated alpha-fetoprotein due to acute exacerbation of chronic hepatitis B without any malignancy, and a decrease in this tumor marker simultaneous with a decrease in hepatitis B virus deoxyribonucleic acid copy number on entecavir treatment. This case report is important due to the rarity of the case; furthermore, it provides details of a diagnostic process for a variety of benign diseases and malignant tumors that should be considered in patients with elevated alpha-fetoprotein. Thus, we present a case report, along with a review, that will be helpful for diagnosis and treatment of patients with elevated alpha-fetoprotein. © 2016 Yoon et al.

引用

共 13 条

[11]

Bae J.S., Park S.J., Park K.B., Paik S.Y., Ryu J.K., Choi C.K., Et al., Acute exacerbation of hepatitis in liver cirrhosis with very high levels of alpha-fetoprotein but no occurrence of hepatocellular carcinoma, Korean J Intern Med., 20, pp. 80-85, (2005)

[12]

Yao F.Y., Dramatic reduction of the alpha-fetoprotein level after lamivudine treatment of patients with chronic hepatitis B virus infection and cirrhosis, J Clin Gastroenterol., 36, pp. 440-442, (2003)

[13]

Patil M., Sheth K.A., Adarsh C.K., Elevated alpha fetoprotein, no hepatocellular carcinoma, J Clin Exp Hepatol., 3, pp. 162-164, (2013)

← 1 2 →