A case of HBV carrier rapidly progressed to cirrhosis after acute onset with relatively high serum levels of .ALPHA.-fetoprotein as compared with transaminase.

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A 21-year-old girl student having positive HBsAg and normal serum levels of GPT since 18 years old showed an acute onset of hepatitis with nausea and vomiting, followed by elevations of serum transaminases and bilirubin. Serum α-fetoprotein levels were relatively high, reaching 1, 237ng/ml, at nearly maximum rises in GOT of 175 KU and in GPT of 137 KU. Histology showed chronic active hepatitis with positive AFP stain among injured hepatocytes remaining in necrotic areas. After IFN treatment, she was seroconverted from HBeAg (+) to HBeAb (+), although transaminase and AFP levels remained slightly elevated, and development of cirrhosis was confirmed peritoneoscopically after 2 years of follow-up, suggesting that AFP elevation is an ominous sign representing severe liver injury rather than a simple hepatocyte regeneration after liver cell necrosis.
社団法人日本肝臓学会の論文