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World J Gastroenterol. Aug 14, 2006; 12(30): 4906-4907
Published online Aug 14, 2006. doi: 10.3748/wjg.v12.i30.4906
Published online Aug 14, 2006. doi: 10.3748/wjg.v12.i30.4906
Alpha-1-antitrypsin deficiency resulting in a hitherto unseen presentation of hepatocellular carcinoma: Polycythemia but with normal alpha fetoprotein
David Ryan Owen, Ramachandran Sivakumar, Eui-Sik Suh, Murugiah Seevaratnam, Department of Geriatric Medicine, Area Q111, Queen Elizabeth II Hospital, Howlands, Welwyn Garden City, Hertfordshire, AL7 4HQ, United Kingdom
Author contributions: All authors contributed equally to the work.
Correspondence to: David Ryan Owen, Department of Geriatric Medicine, Area Q111, Queen Elizabeth II Hospital, Howlands, Welwyn Garden City, Hertfordshire, AL7 4HQ, United Kingdom. david.owen@nhs.net
Telephone: +44-780-1140800 Fax: +44-208-4556190
Received: March 17, 2006
Revised: April 11, 2006
Accepted: April 21, 2006
Published online: August 14, 2006
Revised: April 11, 2006
Accepted: April 21, 2006
Published online: August 14, 2006
Abstract
Polycythemia is a known paraneopastic manifestation of hepatoma, but only in the presence of alpha-fetopro (AFP). We present a case of polycythemia in the absence of AFP, and suggest concurrent alpha-1-antitrypsin deficiency as the cause for breaking this rule. We also suggest a reason for the apparent constant conjunction between polycythemia and AFP in hepatoma.
Keywords: Hepatoma; Polycythemia; Alpha 1 anti trypsin; Ephrin-A; Alpha-fetopro