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What does it mean if you test positive for both ANA and AMA at the same time. I also have no symptoms of any problem.
My ALP is 154 (end of normal range 129) and my GGT is increased also.
Thank you for your response
“You ask an interesting question about ANA and AMA, with a mildly elevated alkaline phosphatase and an elevated GGT. ANA stands for anti-nuclear antibody and is seen in high titers in some patients with systemic lupus erythematosis (SLE), an immune-mediated disease that can affect multiple organs (joints, kidneys, etc). ANA can be positive in patients with autoimmune hepatitis, an immune-mediated inflammatory disease of the liver. Also, ANA can be positive when there is no disease present at all. So, it is important to put these types of results into a proper context.
AMA stands for anti-mitochondrial antibody and is seen in patients who have primary biliary cirrhosis, a chronic liver disease that affects the microscopic bile ducts in the liver. But again, AMA can be seen in the absence of any liver disease, although I feel that AMA is a bit more specific than ANA.
Finally, we sometimes see patients who have both a positive AMA and ANA, and sometimes they have overlapping features of both AIH and PBC. In most of these situations, liver biopsy is an important diagnostic tool to sort out these various liver conditions. Hope this helps somewhat.” Dr. Bruce R. Bacon
My gastroenterologist prescribed statin Livalo because my cholesterol is high. My question is can someone with PBC take a statin? I am fearful of the side effects as it is – but the Livalo website itself says “DO NOT TAKE IF YOU HAVE ACTIVE LIVER DISEASE”. Do you have any advice? Thank you.
“Statins have been rarely associated with liver enzyme elevations but there is no medical evidence to support the statements that statins should not be used in people with liver disease. We often here these statements on TV ads for statins and find them in the print ads too. This issue has been studied extensively over the past 5-10 years and there has been no findings to indicate that we should be worried in terms of liver problems.” Dr. Brent A. Tetri
I am wondering if pbc can cause muscle twitching?
“We are not aware of any association between PBC and muscle twitching” Dr. Brent A. Tetri
I am male and had a positive AMA test, and a biopsy with no signs of the disease. Had a CAT scan too. After all that, both my Gastroenterologist and my GP says its a false positive. Is their such thing as a false positive on an AMA test?
“A positive AMA (anti-mitochondrial antibody) test cannot really be considered a false positive because we don’t have good data on what happens over years to people with this positive test but no evidence of PBC. The first question is why the AMA test was performed. If the alkaline phosphatase is elevated, then a liver biopsy should be considered to further assess the possibility of primary biliary cirrhosis, or PBC. Note that having this disease does not mean that a person has cirrhosis, it just means that it is possible for it to progress to cirrhosis if left untreated. If the alkaline phosphatase is normal, then it and the other liver enzymes (ALT and AST) should be monitored at least annually. If increases are noted, then a liver biopsy should be considered at that point.” Dr. Brent A. Tetri
I’ve recently been diagnosed with PBC, stage 2, with a positive AMA and liver biopsy. My gastroenterologist started me on Ursodiol 250 mg three times a day. He said it would take about four months before we know if it is working by my lab results. I live in the greater St. Louis area and I wonder if I should be followed by SLUH? I feel that a teaching hospital may b3e a better choice for me. Thank you for your thoughts.
“It sounds as if the diagnosis is accurate with the positive AMA and a consistent liver biopsy. The usual dose of ursodeoxycholic acid should be 13 to 15 mg per kg per day in divided dose. We would be happy to see you at the SLU Liver Center. We follow many patients with PBC.”Dr. Brent A. Tetri
I am a 56-year-old man with PBC. Everyone in my family on my father’s side died from liver disease. I have a very difficult time with lack of energy. I sometimes catch myself falling asleep in my chair. I could lose my job because of it. I am just always fatigued. I am taking Ursodiol for my PBC but is there anything I can take to help me with fatigue?
There are so many things on the web but I don’t want to take something that makes my PBC worse. I also can’t seem to stop gaining weight even with diet and exercise. Any suggestions would be helpful.
“The fatigue of PBC is well known and there are no approved treatments in this setting. There are medications that can b3e used to increase a person’s level of wakefulness but whether this approach would be appropriate for you would be a decision for your primary care provider. PBC is not known to be worsened by these medications.
Weight gain as we get into our 50’s is very common and indeed frustrating. The beset and healthiest approach is lifestyle modification that includes focusing on eating healthy foods in reasonable portion sizes while avoiding fast foods, sugar sweetened beverages and restaurant portion sizes. Exercise should be a mix of aerobic activities and strength training on a rregular basis. you can search the internet for the Harvard Healthy Eating Pyramid for some excellent and specific advice.”
My wife is 63, was diagnosed with auto-immune hepatitis 6 years ago and has severe cirrhosis. She currently takes Azathioprine (generic for Imuran) 50 MG tablet, two tablets, once a day and it is doing pretty well. She sometimes seems depressed and cries when she worries about her condition or when her family asks how she is doing. Our primary care physician has suggested that a mild anti-depressant might help. She prescribed 25 MG Sertraline HCL (generic for Zoloft) one tablet daily. We are somewhat concerned that it might do more harm to her liver after reading the patient information data provided by the pharmacy. She is really handling her depression (if that is what is wrong) pretty well other than the occasional tears. Question: Is her use of the Sertraline worth the risk? She has not taken any of it yet. Thanks?
“We are certainly happy to hear that you are in the care of a good hepatologist. Your situation is clearly very complicated and without sitting down with you, going through the details and looking at your liver biopsies, we really are not in a position to comment on your diagnoses and treatment. Fatigue is a known side effect of chronic liver disease, especially PBC. Similarly, OSA is a common contributor to fatigue. There are some data to suggest that OSA might contribute to liver damage in NASH, so it’s not unreasonable to be thinking along these lines. We wish you the best is sorting this out.” Dr. Brent A. Tetri
I’m hoping someone can help me out. I’m a 22 yr old seemingly healthy male. About a year ago I had abnormal lfts. I was referred to a G.I. and tested for pretty much everything from what he told me. All which were negative test. I’ve also had ultrasounds done. CT and MRI. As well as a hyda scan. All showed nothing. I was then ordered to have a liver biopsy. The nurse called me and said they are puzzled and they want to send my biopsy to a “better” lab and want me to be tested for ANA or AMA. I guess to rule out PBC? I’m just lost and scared through all this. I can’t seem to get a straight answer and they act like they really don’t know what’s going on. I respect their work and like my doctor. Can you help me out? Maybe I’m ok? Thanks for any help you can provide.
“Although we have a lot of good blood tests to identify specific causes of liver disease, sorting out the causes of elevated liver enzymes can be difficult at times. It sounds like you are in one of those situations. It is always a good idea to get a second opinion on the interpretation of a liver biopsy when the answer is not clear. Diseases such as Wilson’s disease can be particularly difficult to diagnose and may require a number of different tests such as blood tests, a liver biopsy, a 24 hour urine collection and even an eye examination by an ophthalmologist.” Dr. Dr. Brent A. Tetri
My wife has liver PBC stage 2. diagnosed in 2007. She is 34 yrs old, we have 2 children ages 13 and 5 and I’ve noticed within the past 2 years that she has become withdrawn. She seems lost in her own mind? She seems not to care much about me or our kids. She’s kind of heartless and has no feelings anymore. I don’t know what to do anymore. Is this part of her PBC condition? I help her out around the house I’m good to the kids, and work hard to support her in so many ways. I never get a thank you. She’s still very itchy. She takes her meds. She also no longer wants to be touched. Any information would help me understand. Thanks.