Autoimmune Hepatitis

Hello.  I was diagnosed with Sarcoidosis in 2008 which was confirmed by biopsy.  Since then I have tested positive for RA and my ANA has been as high as 1:5000 currently it is 1350 and always a speckled pattern.  When I was diagnosed with the Sarc I was prescribed Azathioprine which I found out over the three years I took it has damaged my pancreas and I am left with debilitating chronic pancreatitis.  My liver enzymes over the years have been elevated off and on but no jaundice just fatty liver.  Because my ANA is so high and I tested positive for the RA they went ahead and tested me for lupus.  The lupus came back negative but I did test positive for the AntiSmooth Muscle Antibodys which I guess means auto immune hepatitis.  My question is:  Is there anyway you can have a false positive?  I take the following meds.

*Lamictal
*Welbutrin
*Zocor
*Protonix
*Vicodin
*Levsin
*Benedryl
*Seroquel

Like I said I've had liver stuff off and on but I'm just not sure.  Thanks for all your help.

[Red_Star]

ASMA - Anti-Smooth Muscle Antibody can be seen in infectious mononucleosis & other viral infections, Systemic Lupus Erythematosus (SLE),  breast & ovarian carcinoma, and melanoma. It can also be seen in about 50% of cases of primary biliary cirrhosis, alcoholic related cirrhosis, and cases of biliary duct obstruction.  

At a starting dilution of 1:20, there are many false positives for ASMA at this low titre level. ASMA is found positivity in 1.2% of "normal" people under age 40 and in 3.5% over 70 years of age.

Associations with elevated levels of ASMA antibodies:

Autoimmune (chronic active) hepatitis (AIH): 50 - 80% of cases, 70% at >1:1002; >1:160 is significant serologic evidence -  suspicious for autoimmune hepatitis, especially if liver biopsy contains plenty of plasma cells  To note: there have been documented cases of levels >1:160 that were not AIH.  

Primary biliary cirrhosis 0 - 50% of cases

Cryptogenic cirrhosis 0 - 1% of cases  

Viral hepatitis 1 - 2% of cases

[karajo]

Welcome to the forum.  So sorry to hear about your health problems.  

You might want to post your question in the hepatitus (hepatitis) autoimmune forum.

[Red_Star]

ASMA - Anti-Smooth Muscle Antibody can be seen in infectious mononucleosis & other viral infections, Systemic Lupus Erythematosus (SLE),  breast & ovarian carcinoma, and melanoma. It can also be seen in about 50% of cases of primary biliary cirrhosis, alcoholic related cirrhosis, and cases of biliary duct obstruction.  

At a starting dilution of 1:20, there are many false positives for ASMA at this low titre level. ASMA is found positivity in 1.2% of "normal" people under age 40 and in 3.5% over 70 years of age.

Associations with elevated levels of ASMA antibodies:

Autoimmune (chronic active) hepatitis (AIH): 50 - 80% of cases, 70% at >1:1002; >1:160 is significant serologic evidence -  suspicious for autoimmune hepatitis, especially if liver biopsy contains plenty of plasma cells  To note: there have been documented cases of levels >1:160 that were not AIH.  

Primary biliary cirrhosis 0 - 50% of cases

Cryptogenic cirrhosis 0 - 1% of cases  

Viral hepatitis 1 - 2% of cases

[jennpugli]

Thank you for the info the first test didn't contain a titre so I just had more bloodwork done for the titre and a repeat ana.  At this point it would not surprise me one bit for it to be positive I'm just a little confused that if I am truely positive why am I not having more hep symptoms?  I guess thats good I don't want to wish anymore bad stuff on me.  I'll let you know how it turns out.

[jennpugli]

Hello.  I got my blood tests results back and the AntiSmooth Muscle came back negative.  This has everyone confused so I was asked to contact my doctor at UPenn.  Because the pain I have is so massive we're going to repeat everything.  The USEndoscopy, bloodwork, small bowel and I think she want's me to swallow that pill that takes pictures of your insides.  I hadn't seen her in a few months and honestly I think she was frustrated because it would seem nothing would be easy to find.  I have a few of the characistics of pancreatitis.  Its been a year since we've done all this stuff so now maybe some new info will come to light.  Still confused but hopefully some clarity will soon follow.