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. 1976 Aug;17(8):576–580. doi: 10.1136/gut.17.8.576

Prognostic value of serum alpha-fetoprotein in fulminant hepatic failure including patients treated by charcoal haemoperfusion.

I M Murray-Lyon, A H Orr, B Gazzard, J Kohn, R Williams
PMCID: PMC1411314  PMID: 61904

Abstract

Serum alpha-fetoprotein (AFP) levels have been measured sequentially by a radio-immunoassay method in 64 patients with fulminant hepatic failure. In 15 of the 64 patients (23%) AFP levels were raised but in only two did they exceed 500 ng/ml. Of the 23 survivors 11 (48%) had raised AFP levels compared with four of the 41 (9-8%) fatal cases (P less than 0-005). This rise in AFP levels was found early after the development of grade IV coma and constitutes an encouraging prognostic sign at a time when the liver function tests and EEG are unhelpful. A radioimmunoassay must be used if these small but significant rises in plasma concentration are to be detected. Twelve patients survived without showing a rise in plasma AFP at anytime during the illness. The four fatal cases who had raised AFP levels all had serious complications of fulminant hepatic failure. Charcoal haemoperfusion did not seem to increase the survival of AFP negative patients.

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Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Abelev G. I. Alpha-fetoprotein in ontogenesis and its association with malignant tumors. Adv Cancer Res. 1971;14:295–358. doi: 10.1016/s0065-230x(08)60523-0. [DOI] [PubMed] [Google Scholar]
  2. Bloomer J. R., Waldmann T. A., McIntire K. R., Klatskin G. alpha-fetoprotein in noneoplastic hepatic disorders. JAMA. 1975 Jul 7;233(1):38–41. doi: 10.1001/jama.233.1.38. [DOI] [PubMed] [Google Scholar]
  3. Bloomer J. R., Waldmann T. A., McIntire R., Klatskin G. Relationship of serum alpha-fetoprotein to the severity and duration of illness in patients with viral hepatitis. Gastroenterology. 1975 Feb;68(2):342–350. [PubMed] [Google Scholar]
  4. Gazzard B. G., Portmann B., Murray-Lyon I. M., Williams R. Causes of death in fulminant hepatic failure and relationship to quantitative histological assessment of parenchymal damage. Q J Med. 1975 Oct;44(176):615–626. [PubMed] [Google Scholar]
  5. Karvountzis G. G., Redeker A. G. Relation of alpha-fetoprotein in acute hepatitis to severity and prognosis. Ann Intern Med. 1974 Feb;80(2):156–160. doi: 10.7326/0003-4819-80-2-156. [DOI] [PubMed] [Google Scholar]
  6. Kew M. Alpha-fetoprotein in primary liver cancer and other diseases. Gut. 1974 Oct;15(10):814–821. doi: 10.1136/gut.15.10.814. [DOI] [PMC free article] [PubMed] [Google Scholar]
  7. Kohn J., Weaver P. C. Serum-alpha 1-fetoprotein in hepatocellular carcinoma. Lancet. 1974 Aug 10;2(7876):334–336. doi: 10.1016/s0140-6736(74)91705-x. [DOI] [PubMed] [Google Scholar]
  8. Leek A. E., Ruoss C. F., Kitau M. J., Chard T. Maternal plasma alphafetoprotein levels in the second half of normal pregnancy: relationship to fetal weight, and maternal age and parity. Br J Obstet Gynaecol. 1975 Aug;82(8):669–673. doi: 10.1111/j.1471-0528.1975.tb00704.x. [DOI] [PubMed] [Google Scholar]
  9. Opolon P., Hirsch-Marie H., Gateau P., Caroli J. Apparition d'alpha-1-foetoprotéine circulante au cours de l'atrophie aiguë du foie. Résultats préliminaires. Ann Med Interne (Paris) 1973 Dec;124(12):883–888. [PubMed] [Google Scholar]
  10. Portmann B., Talbot I. C., Day D. W., Davidson A. R., Murray-Lyon I. M., Williams R. Histopathological changes in the liver following a paracetamol overdose: correlation with clinical and biochemical parameters. J Pathol. 1975 Nov;117(3):169–181. doi: 10.1002/path.1711170307. [DOI] [PubMed] [Google Scholar]
  11. Purves L. R., Purves M. Serum alpha-feto-protein. VI. The radio-immunoassay evidence for the presence of AFP in the serum of normal people and during pregnancy. S Afr Med J. 1972 Sep 9;46(36):1290–1297. [PubMed] [Google Scholar]
  12. Ruoslahti E., Salaspuro M., Pihko H., Andersson L., Seppälä M. Serum alpha-fetoprotein: diagnostic significance in liver disease. Br Med J. 1974 Jun 8;2(5918):527–529. doi: 10.1136/bmj.2.5918.527. [DOI] [PMC free article] [PubMed] [Google Scholar]
  13. Sell S., Nichols M., Becker F. F., Leffert H. L. Hepatocyte proliferation and alpha 1-fetoprotein in pregnant, neonatal, and partially hepatectomized rats. Cancer Res. 1974 Apr;34(4):865–871. [PubMed] [Google Scholar]
  14. Trey C., Burns D. G., Saunders S. J. Treatment of hepatic coma by exchange blood transfusion. N Engl J Med. 1966 Mar 3;274(9):473–481. doi: 10.1056/NEJM196603032740901. [DOI] [PubMed] [Google Scholar]

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