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Abstract

Alpha fetoprotein is a fetal specific glycoprotein which falls rapidly after birth. High level of alpha fetoprotein is suspicious of hepatocellular carcinoma but may be elevated in chronic viral hepatitis. A 35-year-old presented to us with jaundice for 7 days. He had chronic hepatitis B infection for last 12 months and was taking medicines irregularly for same. He had high alpha fetoprotein levels (740.9 ng/ml) without evidence of hepatocellular carcinoma which reduced with antiviral therapy. Such elevation can be explained due to hepatic inflammation and viral replication.

Keywords: alpha fetoprotein (AFP), hepatocellular carcinoma (HCC), hepatitis B infection

Abbreviations: AFP, alpha fetoprotein; HCC, hepatocellular carcinoma; AST, aspartate aminotransferase; ALT, alanine aminotransferase; ALP, alkaline phosphatase; GGT, gamma glutamyl transferase; ANA, antinuclear antibody; anti-LKM-1, anti-liver kidney microsomal antibody; ASMA, anti-smooth muscle antibody; HBeAg, hepatitis B virus e antigen; LCA, lens culinaris agglutinin

Alpha fetoprotein (AFP) is a fetal specific glycoprotein produced primarily by the fetal liver. Serum AFP level falls after birth and its synthesis is suppressed in adult life. Serum AFP can become elevated in some disease states particularly hepatocellular carcinoma (HCC), but may still be non-specific finding in patients with chronic viral hepatitis. We present a case with elevated AFP without evidence of a tumor. Serum AFP levels decreased in response to antiviral therapy.