Whatever else comes out of this, it’s a great argument for not doing tumour marker “profiles”! Mike
Sent from my iPhone
> On 29 May 2019, at 13:38, Soha Zouwail <[log in to unmask]> wrote:
>
> Dear ACB collective brains
>
> I would value your suggestion on the following conundrum. A 70 y old gentleman who had aortic valve replacement in April 2018. During his pre-operative assessment, he was noted to have an unintentional weight loss of about 14kg and poor appetite over two months. Tumour markers panel was requested including CEA, Ca19-9, PSA, HCG, AFP and LDH in addition to hepatitis serology. All his results were normal except for AFP which was raised at 121 Ku/L (Abbott). He was also reviewed by Urology team and further investigations were initiated including CT abdomen, liver and testicular US but no abnormality found. AFP was analysed on Roche which gave similar result. The sample was run on serial dilutions and even with PEG precipitation (to exclude a Macro though never seen one reported). The patient had a myeloma screen, immunoglobulins, A-1 antitrypsin, liver autoantibodies and iron studies and all were unremarkable. He even had AFP gene sequencing but hereditary persistence of AFP syndrome was NOT confirmed. He feels much better after his op and has regained weight. Results are documented below.
>
> I am at loss at what is the cause of this raised AFP and would value your input. I am thinking that Hereditary persistence AFP remains a possibility, shall I suggest checking his children’ AFP level and if they have a raised AFP then this makes the diagnosis very likely.
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> Many thanks
>
> BW
> Soha
>
>
> Dr Soha Zouwail, MD, PhD, FRCPath
> Consultant Chemical Pathologist
> Medical Biochemistry and Immunology
> University Hospital of Wales
> Cardiff
> CF14 4XW
> Tel: 02920 748351
>
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