Serum cholinesterase (ChE) is a glycoprotein that is primarily formed in parenchymal cells in the liver, the level of which falls in patients with liver cirrhosis and hepatocellular carcinoma (HCC) because the synthesis of ChE is reduced to some extent in such conditions (
1.). By contrast, hypercholinesterasemia is often observed in a variety of clinical conditions, such as nephrotic syndrome, fatty liver, diabetes mellitus, hyperthyroidism and various types of primary tumors, including ovarian carcinomas (
- Brown SS
- Kalow W
- Pilz W
- Whittaker M
- Woronick CL
The plasma cholinesterases: a new perspective.
Adv Clin Chem. 1981; 22: 82-83
2.), and glioblastomas (
- Drews U
Cholinesterase in embryonic development.
Progr Histochem Cytochem. 1975; 7: 1-52
3.). HCC is frequently associated with many paraneoplastic syndromes (
- Ord MG
- Thompson RHS
Pseudocholinesterase activity in central nervous system.
Biochem J. 1952; 51: 245-251
- McFadzean AJS
- Todd D
- Tso SC
Erythrocytosis associated with hepatocellular carcinoma.
Blood. 1967; 29: 808-811
- Becker DJ
- Sternberg MS
- Kalser MH
Hepatoma associated with hypoglycemia, polycythemia, and hypercalcemia.
JAMA. 1963; 186: 1018-1019
6.). Only three cases have been reported in association with hypercholinesterasemia (
- Margolis S
- Homcy C
Systemic manifestations of hepatoma.
Medicine. 1972; 51: 381-391
- Kodama T
- Okada Y
- Komachitani K
- Ohbayashi A
- Harada E
- Ohtake H
- et al.
Hypercholinesterasemia as a new paraneoplastic syndrome.
Acta Hepatol Jpn. 1980; 21 (in Japanese): 1393
8.) but previous reports have not provided direct evidence that the carcinoma cells could produce the ChE. We present two such cases and provide direct evidence of ChE production in HCC.
- Tajiri J
- Nishizono Y
- Fujiyama S
- Sagara K
- Sato T
- Shibata H
Hypercholinesterasemia in patients with hepatocellular carcinoma: a new paraneoplastic syndrome.
Gastroenterol Jap. 1983; 18: 137-141
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- The plasma cholinesterases: a new perspective.Adv Clin Chem. 1981; 22: 82-83
- Cholinesterase in embryonic development.Progr Histochem Cytochem. 1975; 7: 1-52
- Pseudocholinesterase activity in central nervous system.Biochem J. 1952; 51: 245-251
- Erythrocytosis associated with hepatocellular carcinoma.Blood. 1967; 29: 808-811
- Hepatoma associated with hypoglycemia, polycythemia, and hypercalcemia.JAMA. 1963; 186: 1018-1019
- Systemic manifestations of hepatoma.Medicine. 1972; 51: 381-391
- Hypercholinesterasemia as a new paraneoplastic syndrome.Acta Hepatol Jpn. 1980; 21 (in Japanese): 1393
- Hypercholinesterasemia in patients with hepatocellular carcinoma: a new paraneoplastic syndrome.Gastroenterol Jap. 1983; 18: 137-141
© 1999 Published by Elsevier Inc.