Blood Tests

[Nole1970]

What is a test called DNA AB, Native?

[txsilver]

That is a blood test that is run to look for antibodies that may help the doctor identify what is causing an illness.  What symptoms do you have?  Do you have your lab results?

[Nole1970]

I have had elevated liver enzymes for over 5 months. The blood test, DNA AB, Native, came back normal.  I was wondering what the doctor was testing me for.  I looked up the other tests that the doctor ran on the Internet and found that he tested me for Lupus, Autoimmune Hepatitis, Hepatitis A, B, and C, Primary Biliary Cirrhosis, several blood cancers, and many other horrible diseases, but all of that bloodwork came back normal.  I've had an abdominal CT scan, a MRI, and a MRCP (specific MRI for the liver/pancreas).  I  had my gallbladder removed 10 years ago so it's not gallstones.  All of my scans have come back inconclusive so  I'm back to square one just watching and waiting to see if the liver functions test (LFT) goes back to normal over time or continues to stay elevated.  The next step is a liver biopsy.  I have no other symptoms other than an occasional slight ache in my right side and that may be due to a hysterical reaction on my part rather than an actual illness.  I have no itching, no undue fatigue, and no dizziness.  I am a post-menopausal, 59 year old woman who has 2 grown children.  I was on Hormone Replacement Therapy (HRT) until 5 Aug 2008 and I am having hot flashes.  I did show some normalizing on 2 out of 3 of my failed LFT in September.  I'm hoping that HRT was the culprit.  I'm looking forward to my October 26th LFT.

[txsilver]

From what I can tell, the DNA AB Native test is also for Lupus.  If your liver enzymes are elevated and have been for 5 months and the tests are all coming back normal, a biopsy sounds like the logical next step unless you want to get a second opinion before moving forward with that.  I am guessing you are seeing a liver specialist.  Have they brought in an infectious disease expert or a rheumatologist to consult?  It might be worth asking about.

[Nole1970]

I saw a gastroenterologist on Sept 16th and I will see a liver specialist on Nov 5th.  No, I haven't seen an infectious disease specialist or rheumatologist yet, but I'll inquire about that.  My grandfather died of complications of rheumatoid arthritis and my sister has rheumatoid arthritis, although it's currently in remission.
I do want to get a second opinion before I get a liver biopsy.  

[txsilver]

Sounds like you are on the right track.  Please let us know what you find out and how you are doing.  Will be keeping you in my thoughts.

[Nole1970]

I looked back at my old postings today and noticed that I never wrote you back to tell you the outcome of the medical testing that I have been going through over the past 9 months.  You had responded to my query about numerous blood tests that my gastroenterologist ran back on 16 Sep 2008 which all came back negative except my liver enzymes remained elevated.  I switched to a liver specialist in Nov and had more blood tests, a MRCP, a HIDA scan, CT scan, and finally, a liver biopsy in Dec.  All of my blood tests continued to be normal except the liver enzymes and  the GGT that the liver specialist ran.  I did have a slight elevation in another blood test to indicate that I might have Celiac Disease so I had a Panendoscopy for that which came out positive for Celiac (CD).  The liver biopsy showed some abnormalities so my doctor sent my slides to Mayo Clinic in Jacksonville for a second opinion.  It was determined that I have negative AMA Primary Bilary Cirrhosis (PBC).  The good news is that my case was caught so early that I have no fibrosis or cirrhosis yet.   I received news of that diagnosis on 14 Jan 2009 and was immediately started on Urso Forte 500mg BID.  I saw my liver specialest on 25 Feb and she was thrilled that the medication is dramatically lowing my enzyme levels.  Two of the levels were back to normal and the GGT was almost 50% lower than what it was before.  Urso Forte has some uncomfortable side-effects but it's worth it if it saves my liver.  I am also on a very strict, restrictive diet because of the PBC and CD.  I'll have more blood tests next week and see my doctor again on 25 Mar to see how I'm progressing with the medication.

One of the side-effects that we're watching is arthritis (swelling) that's developing in the lower joints of my fingers.  There's nothing that we can do about it if the drug has caused it, however, because Ursodiol is the only drug approved by the FDA for PBC.  I'll just have to deal with this and the IBS, fatigue, etc. that goes along with the disease/medication.