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One Case of Abnormal Elevation of PIVKA-II
Background:
Protein Induced by Vitamin K Absence or Antagonist II (PIVKA-II) is a serum biomarker that is specifically elevated in hepatocellular carcinoma (HCC) and has important value in early diagnosis, prognosis evaluation, and recurrence prediction of liver cancer.
Methods:
We report a case of extreme elevation of serum PIVKA-II due to the use of warfarin.
Results:
The patient's abdominal ultrasound and enhanced CT examinations showed no significant abnormalities. The patient has been taking warfarin for atrial fibrillation, and after supplementing with vitamin K, the PIVKA-II level significantly decreased. Therefore, the PIVKA-II results were extremely elevated, which is believed to be caused by taking warfarin.
Conclusions:
When patients take warfarin anticoagulant therapy, it may cause an extreme increase in PIVKA-II results. Laboratory staff and clinical doctors should consider the existence of this situation and avoid unnecessary examinations and treatments for patients.

