Elevated AFP in the Absence of Hepatic Malignancy in a Patient with Acute Hepatitis

Jacklyn Manaog So-Cabahug; Rafael Chan; Marc Lustre; Janus Ong

doi:doi:10.11648/j.ijg.20210502.18

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Elevated AFP in the Absence of Hepatic Malignancy in a Patient with Acute Hepatitis

Jacklyn Manaog So-Cabahug, Rafael Chan, Marc Lustre, Janus Ong

Published in International Journal of Gastroenterology (Volume 5, Issue 2)

Received: 25 October 2021 Accepted: 12 November 2021 Published: 23 November 2021

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Abstract

Alpha-fetoprotein is a tumor marker used in the clinical diagnosis and monitoring of treatment response in hepatocellular carcinoma (HCC). However, elevated levels are not specific for malignancy as it has been reported in other chronic liver diseases. This paper aims to describe such a case of elevated AFP in a case of acute hepatitis and its pathophysiology. Herein presents a 26-year-old Asian male with jaundice; who had no personal or family history of liver disease, drug or supplement use. The reported alcohol intake was not significant. The laboratory workup revealed hepatocellular type of liver injury (total bilirubin of 478 umol/L, direct bilirubin 401 umol/L, indirect bilirubin 77 umol/L, AST 1135 U/L, ALT 1592 U/L, LDH 53 U/L, ALP 139 u/L), elevated AFP (3337 IU/mL), elevated INR, positive autoimmune panel (ANA, Anti-Sm, Anti-TPO, Anti-TG). The serological examinations revealed a past infection with EBV and CMV, while imaging tests did not show ductal obstruction or the presence of mass lesions. A subsequent liver biopsy demonstrated interface hepatitis. The patient was then treated as a case of autoimmune hepatitis and was started on glucocorticoids with clinical and biochemical improvement including normalization of AFP levels.

Published in	International Journal of Gastroenterology (Volume 5, Issue 2)
DOI	10.11648/j.ijg.20210502.18
Page(s)	86-90
Creative Commons	This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited.
Copyright	Copyright © The Author(s), 2021. Published by Science Publishing Group

Keywords

AFP, Case Report, Acute Hepatitis, EBV

References

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APA Style

Jacklyn Manaog So-Cabahug, Rafael Chan, Marc Lustre, Janus Ong. (2021). Elevated AFP in the Absence of Hepatic Malignancy in a Patient with Acute Hepatitis. International Journal of Gastroenterology, 5(2), 86-90. https://doi.org/10.11648/j.ijg.20210502.18

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ACS Style

Jacklyn Manaog So-Cabahug; Rafael Chan; Marc Lustre; Janus Ong. Elevated AFP in the Absence of Hepatic Malignancy in a Patient with Acute Hepatitis. Int. J. Gastroenterol. 2021, 5(2), 86-90. doi: 10.11648/j.ijg.20210502.18

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AMA Style

Jacklyn Manaog So-Cabahug, Rafael Chan, Marc Lustre, Janus Ong. Elevated AFP in the Absence of Hepatic Malignancy in a Patient with Acute Hepatitis. Int J Gastroenterol. 2021;5(2):86-90. doi: 10.11648/j.ijg.20210502.18

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@article{10.11648/j.ijg.20210502.18,
  author = {Jacklyn Manaog So-Cabahug and Rafael Chan and Marc Lustre and Janus Ong},
  title = {Elevated AFP in the Absence of Hepatic Malignancy in a Patient with Acute Hepatitis},
  journal = {International Journal of Gastroenterology},
  volume = {5},
  number = {2},
  pages = {86-90},
  doi = {10.11648/j.ijg.20210502.18},
  url = {https://doi.org/10.11648/j.ijg.20210502.18},
  eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.ijg.20210502.18},
  abstract = {Alpha-fetoprotein is a tumor marker used in the clinical diagnosis and monitoring of treatment response in hepatocellular carcinoma (HCC). However, elevated levels are not specific for malignancy as it has been reported in other chronic liver diseases. This paper aims to describe such a case of elevated AFP in a case of acute hepatitis and its pathophysiology. Herein presents a 26-year-old Asian male with jaundice; who had no personal or family history of liver disease, drug or supplement use. The reported alcohol intake was not significant. The laboratory workup revealed hepatocellular type of liver injury (total bilirubin of 478 umol/L, direct bilirubin 401 umol/L, indirect bilirubin 77 umol/L, AST 1135 U/L, ALT 1592 U/L, LDH 53 U/L, ALP 139 u/L), elevated AFP (3337 IU/mL), elevated INR, positive autoimmune panel (ANA, Anti-Sm, Anti-TPO, Anti-TG). The serological examinations revealed a past infection with EBV and CMV, while imaging tests did not show ductal obstruction or the presence of mass lesions. A subsequent liver biopsy demonstrated interface hepatitis. The patient was then treated as a case of autoimmune hepatitis and was started on glucocorticoids with clinical and biochemical improvement including normalization of AFP levels.},
 year = {2021}
}

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TY  - JOUR
T1  - Elevated AFP in the Absence of Hepatic Malignancy in a Patient with Acute Hepatitis
AU  - Jacklyn Manaog So-Cabahug
AU  - Rafael Chan
AU  - Marc Lustre
AU  - Janus Ong
Y1  - 2021/11/23
PY  - 2021
N1  - https://doi.org/10.11648/j.ijg.20210502.18
DO  - 10.11648/j.ijg.20210502.18
T2  - International Journal of Gastroenterology
JF  - International Journal of Gastroenterology
JO  - International Journal of Gastroenterology
SP  - 86
EP  - 90
PB  - Science Publishing Group
SN  - 2640-169X
UR  - https://doi.org/10.11648/j.ijg.20210502.18
AB  - Alpha-fetoprotein is a tumor marker used in the clinical diagnosis and monitoring of treatment response in hepatocellular carcinoma (HCC). However, elevated levels are not specific for malignancy as it has been reported in other chronic liver diseases. This paper aims to describe such a case of elevated AFP in a case of acute hepatitis and its pathophysiology. Herein presents a 26-year-old Asian male with jaundice; who had no personal or family history of liver disease, drug or supplement use. The reported alcohol intake was not significant. The laboratory workup revealed hepatocellular type of liver injury (total bilirubin of 478 umol/L, direct bilirubin 401 umol/L, indirect bilirubin 77 umol/L, AST 1135 U/L, ALT 1592 U/L, LDH 53 U/L, ALP 139 u/L), elevated AFP (3337 IU/mL), elevated INR, positive autoimmune panel (ANA, Anti-Sm, Anti-TPO, Anti-TG). The serological examinations revealed a past infection with EBV and CMV, while imaging tests did not show ductal obstruction or the presence of mass lesions. A subsequent liver biopsy demonstrated interface hepatitis. The patient was then treated as a case of autoimmune hepatitis and was started on glucocorticoids with clinical and biochemical improvement including normalization of AFP levels.
VL  - 5
IS  - 2
ER  -

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Author Information

Jacklyn Manaog So-Cabahug

Section of Gastroenterology and Digestive Endoscopy, Manila Doctors Hospital, Manila, Philippines
Rafael Chan

Section of Gastroenterology and Digestive Endoscopy, Manila Doctors Hospital, Manila, Philippines
Marc Lustre

Section of Gastroenterology and Digestive Endoscopy, Manila Doctors Hospital, Manila, Philippines
Janus Ong

Section of Gastroenterology and Digestive Endoscopy, Manila Doctors Hospital, Manila, Philippines

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Plain Text BibTeX RIS

APA Style

Jacklyn Manaog So-Cabahug, Rafael Chan, Marc Lustre, Janus Ong. (2021). Elevated AFP in the Absence of Hepatic Malignancy in a Patient with Acute Hepatitis. International Journal of Gastroenterology, 5(2), 86-90. https://doi.org/10.11648/j.ijg.20210502.18

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ACS Style

Jacklyn Manaog So-Cabahug; Rafael Chan; Marc Lustre; Janus Ong. Elevated AFP in the Absence of Hepatic Malignancy in a Patient with Acute Hepatitis. Int. J. Gastroenterol. 2021, 5(2), 86-90. doi: 10.11648/j.ijg.20210502.18

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AMA Style

Jacklyn Manaog So-Cabahug, Rafael Chan, Marc Lustre, Janus Ong. Elevated AFP in the Absence of Hepatic Malignancy in a Patient with Acute Hepatitis. Int J Gastroenterol. 2021;5(2):86-90. doi: 10.11648/j.ijg.20210502.18

Copy | Download

@article{10.11648/j.ijg.20210502.18,
  author = {Jacklyn Manaog So-Cabahug and Rafael Chan and Marc Lustre and Janus Ong},
  title = {Elevated AFP in the Absence of Hepatic Malignancy in a Patient with Acute Hepatitis},
  journal = {International Journal of Gastroenterology},
  volume = {5},
  number = {2},
  pages = {86-90},
  doi = {10.11648/j.ijg.20210502.18},
  url = {https://doi.org/10.11648/j.ijg.20210502.18},
  eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.ijg.20210502.18},
  abstract = {Alpha-fetoprotein is a tumor marker used in the clinical diagnosis and monitoring of treatment response in hepatocellular carcinoma (HCC). However, elevated levels are not specific for malignancy as it has been reported in other chronic liver diseases. This paper aims to describe such a case of elevated AFP in a case of acute hepatitis and its pathophysiology. Herein presents a 26-year-old Asian male with jaundice; who had no personal or family history of liver disease, drug or supplement use. The reported alcohol intake was not significant. The laboratory workup revealed hepatocellular type of liver injury (total bilirubin of 478 umol/L, direct bilirubin 401 umol/L, indirect bilirubin 77 umol/L, AST 1135 U/L, ALT 1592 U/L, LDH 53 U/L, ALP 139 u/L), elevated AFP (3337 IU/mL), elevated INR, positive autoimmune panel (ANA, Anti-Sm, Anti-TPO, Anti-TG). The serological examinations revealed a past infection with EBV and CMV, while imaging tests did not show ductal obstruction or the presence of mass lesions. A subsequent liver biopsy demonstrated interface hepatitis. The patient was then treated as a case of autoimmune hepatitis and was started on glucocorticoids with clinical and biochemical improvement including normalization of AFP levels.},
 year = {2021}
}

Copy | Download

TY  - JOUR
T1  - Elevated AFP in the Absence of Hepatic Malignancy in a Patient with Acute Hepatitis
AU  - Jacklyn Manaog So-Cabahug
AU  - Rafael Chan
AU  - Marc Lustre
AU  - Janus Ong
Y1  - 2021/11/23
PY  - 2021
N1  - https://doi.org/10.11648/j.ijg.20210502.18
DO  - 10.11648/j.ijg.20210502.18
T2  - International Journal of Gastroenterology
JF  - International Journal of Gastroenterology
JO  - International Journal of Gastroenterology
SP  - 86
EP  - 90
PB  - Science Publishing Group
SN  - 2640-169X
UR  - https://doi.org/10.11648/j.ijg.20210502.18
AB  - Alpha-fetoprotein is a tumor marker used in the clinical diagnosis and monitoring of treatment response in hepatocellular carcinoma (HCC). However, elevated levels are not specific for malignancy as it has been reported in other chronic liver diseases. This paper aims to describe such a case of elevated AFP in a case of acute hepatitis and its pathophysiology. Herein presents a 26-year-old Asian male with jaundice; who had no personal or family history of liver disease, drug or supplement use. The reported alcohol intake was not significant. The laboratory workup revealed hepatocellular type of liver injury (total bilirubin of 478 umol/L, direct bilirubin 401 umol/L, indirect bilirubin 77 umol/L, AST 1135 U/L, ALT 1592 U/L, LDH 53 U/L, ALP 139 u/L), elevated AFP (3337 IU/mL), elevated INR, positive autoimmune panel (ANA, Anti-Sm, Anti-TPO, Anti-TG). The serological examinations revealed a past infection with EBV and CMV, while imaging tests did not show ductal obstruction or the presence of mass lesions. A subsequent liver biopsy demonstrated interface hepatitis. The patient was then treated as a case of autoimmune hepatitis and was started on glucocorticoids with clinical and biochemical improvement including normalization of AFP levels.
VL  - 5
IS  - 2
ER  -

Copy | Download