Unfortunately, there is only very limited experience with such minor minor minor AFP elevation. However, in my experience of seeing many children with childhood germ cell tumors, I remember several kids that hav experienced minor undulation of AFP up to levels of 30-50 µg/L, often in association with unspecific viral infection other than hepatic infection.

in such situations, you should shorten the follow-up intervals for the next AFP measurement, if the AFP continues to rise, this becomes more worrisome. However, often you may not see radiographic tumor lesions in MR or CT until the AFP level is higher than 100.

I wish the patient all the best!

By the way, how long is the follow-up time after diagnosis. The risk of relapse is highest in the forst tow years after Dx and significantly decreases thereafter.

Thanks Dominic. Patient diagnosed June 2011, age 18 months, lung secondaries. Received SIOPEL chemotherapy and resection of the liver primary. Apparent remission by March 2012, AFP 2 ng/ml. November 2012, AFP 1 ng/ml. December 2012, AFP 15 ng/ml, coinciding with the previously mentioned gastroenteritis. AFP has since fallen, so it looks likely that the rise was associated with the infection.