Aa
Positive ANA and ASMA
Did anyone test positive for ANA and ASMA? I did and my titres are ANA 1:160 and ASMA 1:20. I have read that it means cirrhosis. Anyone else have this?
Hector,
Thank you for your reply. When I saw my hepatologist he said it is definitely a liver problem...he thought fatty liver at a minimum. He even said it could also possibly be NAFL because my ALT was higher than the AST at times and also because of my LDL being around 150 for years and something about low Vitamin D. But that was before my bloodwork came back positive for ANA/ASMA. He said if it's bad news I will call you about the bloodwork results...and he called. He said we have to re-test in 3 months, so come back in January.
If I had just fatty liver, wouldn't that have shown up on Ultrasound or MRI?
Also, if I had fatty liver, wouldn't it be enlarged? My liver is "bottom size" Normal at 11.4 cm, which sounds small to me....
Thank you for your time.
Thank you for your reply. When I saw my hepatologist he said it is definitely a liver problem...he thought fatty liver at a minimum. He even said it could also possibly be NAFL because my ALT was higher than the AST at times and also because of my LDL being around 150 for years and something about low Vitamin D. But that was before my bloodwork came back positive for ANA/ASMA. He said if it's bad news I will call you about the bloodwork results...and he called. He said we have to re-test in 3 months, so come back in January.
If I had just fatty liver, wouldn't that have shown up on Ultrasound or MRI?
Also, if I had fatty liver, wouldn't it be enlarged? My liver is "bottom size" Normal at 11.4 cm, which sounds small to me....
Thank you for your time.
COMMUNITY LEADER
While individual test results are important, they are only parts of the whole which helps a doctor to develop a diagnosis.
What is the diagnosis your hepatologist has given you?
Are far as cirrhosis...you can rest assured you definitely don't have cirrhosis or any signs or symptoms of it. Besides the typical blood abnormalities of cirrhosis (low platelet count as one example), the ultrasound and MRI would have noted the obvious anatomical changes to the liver and the blood supply surrounding the liver if you had developed cirrhosis. A nodular liver, changes in size of segments of the liver, sign of portal hypertension in the surrounding blood supple are all seen in those with cirrhosis. So there is no worry that you have cirrhosis.
I would follow up with your hepatologist to learn more about any liver disease you may have and how you can best manage it. You may also want to see your primary care doctor regarding the symptoms you are having as stomach pain, weakness and insomnia are not symptoms of liver disease. Continue to abstain from alcohol, which is toxic to the liver, and can make any liver disease worse.
No, I never drank alcohol myself. I developed my cirrhosis (and liver cancer) due to chronic hepatitis C infection which multiple treatments failed to cure. I treated it after my transplant and am now cured of my hepatitis C.
Best of luck to you.
Hector
What is the diagnosis your hepatologist has given you?
Are far as cirrhosis...you can rest assured you definitely don't have cirrhosis or any signs or symptoms of it. Besides the typical blood abnormalities of cirrhosis (low platelet count as one example), the ultrasound and MRI would have noted the obvious anatomical changes to the liver and the blood supply surrounding the liver if you had developed cirrhosis. A nodular liver, changes in size of segments of the liver, sign of portal hypertension in the surrounding blood supple are all seen in those with cirrhosis. So there is no worry that you have cirrhosis.
I would follow up with your hepatologist to learn more about any liver disease you may have and how you can best manage it. You may also want to see your primary care doctor regarding the symptoms you are having as stomach pain, weakness and insomnia are not symptoms of liver disease. Continue to abstain from alcohol, which is toxic to the liver, and can make any liver disease worse.
No, I never drank alcohol myself. I developed my cirrhosis (and liver cancer) due to chronic hepatitis C infection which multiple treatments failed to cure. I treated it after my transplant and am now cured of my hepatitis C.
Best of luck to you.
Hector
1 Comments
As a cirrhosis patient myself, I feel like this information isn't totally accurate?
I have stage 4 cirrhosis, confirmed by two biopsies, a year apart. In 2016 when I was diagnosed, I was decompensated badly. But even so, the majority of my imaging said "Liver: Unremarkable." That's what an ultrasound said just ONE WEEK before my liver failed, and I was diagnosed with cirrhosis for the first time. And since then, 4 out of 5 times that I get imaging - CT, MRI, or ultrasound - they see no evidence of cirrhosis. Yet, here I am, with absolute, for sure, stage 4 cirrhosis. So, imaging isn't always accurate for everyone.
Labs don't always tell the whole story either, since my labs are always pretty much normal, even my liver panel.
And, stomach pain, weakness, and insomnia can definitely be signs that relate to liver disease in general, cirrhosis in particular. Cirrhosis can flip your sleep/wake cycle, causing excessive daytime drowsiness and terrible insomnia. Weakness is common, due to muscle wasting, and just general fatigue. Stomach pain isn't as directly related to cirrhosis, but definitely not uncommon, since the liver is an important part of the GI system, and people use the term "stomach" pain to describe a wide variety of pain that's actually abdominal pain.
The original post also mentioned the light, clay colored stools, which is a big indicator of something liver/bile duct/gallbladder/all three related.
I have stage 4 cirrhosis, confirmed by two biopsies, a year apart. In 2016 when I was diagnosed, I was decompensated badly. But even so, the majority of my imaging said "Liver: Unremarkable." That's what an ultrasound said just ONE WEEK before my liver failed, and I was diagnosed with cirrhosis for the first time. And since then, 4 out of 5 times that I get imaging - CT, MRI, or ultrasound - they see no evidence of cirrhosis. Yet, here I am, with absolute, for sure, stage 4 cirrhosis. So, imaging isn't always accurate for everyone.
Labs don't always tell the whole story either, since my labs are always pretty much normal, even my liver panel.
And, stomach pain, weakness, and insomnia can definitely be signs that relate to liver disease in general, cirrhosis in particular. Cirrhosis can flip your sleep/wake cycle, causing excessive daytime drowsiness and terrible insomnia. Weakness is common, due to muscle wasting, and just general fatigue. Stomach pain isn't as directly related to cirrhosis, but definitely not uncommon, since the liver is an important part of the GI system, and people use the term "stomach" pain to describe a wide variety of pain that's actually abdominal pain.
The original post also mentioned the light, clay colored stools, which is a big indicator of something liver/bile duct/gallbladder/all three related.
Thank you Hector. I saw a hepatologist at a leading hospital and all he did was prescribe vitamin e and told me to come back in 3 months. My labs are normal except for the ANA/ASMA but I am so weak and my arms and legs really ache. I have RUQ pain, insomnia, pain in my stomach especially after eating and light colored stools. I have been sick for almost 4 months now. My Ultrasound said my liver was "bottom normal" size at 11.4 cm and my CT scan showed subtle heterogeneous attenuation in right interior lobe could be fatty infiltration. MRI (no contrast) showed nothing. I just feel so weak and it is hard for me to work or do any normal activities. However, I have made myself ride my bicycle 1 mile per day and I am doing 15 pushups to help with the arm pain. I have a history of drinking 2-3 glasses of wine most days, but not every day. I have not had any alcohol in almost 4 months.... Was your cirrhosis alcohol-related? Thank you.
Thanks fntn,
I have read that the high titres indicate auto-immune, but that they low titres represent cirrhosis. My globulins are not elevated at this time. All my bloodwork is fairly normal, except the ANA and ASMA, but my CT scan showed subtle heterogeneous attenuation in right interior lobe could be fatty infiltration. My symptoms are RUQ pain, burning/pain between stermum and belly button, pale stools with yellow/orange tint. insomnia, weakness, ache in upper arms/legs, white spots up and down my arms and legs, cholesterol spots on face/eyelids, dry eyes. I saw a hepatologist at a leading hospital and all he did is prescribe 800 mg vitamin e and tell me to come back in 3 months.....
Thank you for your response. Any further information would be greatly appreciated. Meanwhile I can barely get myself to work and I worry about the future.
I have read that the high titres indicate auto-immune, but that they low titres represent cirrhosis. My globulins are not elevated at this time. All my bloodwork is fairly normal, except the ANA and ASMA, but my CT scan showed subtle heterogeneous attenuation in right interior lobe could be fatty infiltration. My symptoms are RUQ pain, burning/pain between stermum and belly button, pale stools with yellow/orange tint. insomnia, weakness, ache in upper arms/legs, white spots up and down my arms and legs, cholesterol spots on face/eyelids, dry eyes. I saw a hepatologist at a leading hospital and all he did is prescribe 800 mg vitamin e and tell me to come back in 3 months.....
Thank you for your response. Any further information would be greatly appreciated. Meanwhile I can barely get myself to work and I worry about the future.
It doesn't indicate cirrhosis but it may be causing any number of liver issues. *** Hector mentioned, AIH is one of the major autoimmune liver diseases but there are several hepatobiliary diseases as well. I have one myself, PSC, and my ANA levels bounce around 1:640. And yes, you will need a good liver specialist to help you get a proper diagnosis and treatment. Good luck and hope all goes well.
1 Comments
lol, must have hit one too many "s" in the word "As".
COMMUNITY LEADER
The antinuclear antibody (ANA), smooth muscle antibody (SMA), antibody blood tests are used as only part of a workup for the diagnosis of AutoImmune Hepatitis which is one form of liver disease. Autoimmune Hepatitis is a complex disease and diagnosis involves many factors.
A positive result does not confirm a disease; it is used in addition to signs and symptoms, specific antibody tests, and liver related tests and imaging findings, such as ultrasound, CT or MRI findings. Treatment may be needed depending on the findings of your medical work up.
Like all liver diseases, the extent of the disease can very widely. Some people can have little liver damage and no signs of their disease while others can have extensive liver damage to the point where they liver can no longer function properly and they will need a liver transplant to continue living.
Scoring systems for chronic liver disease are used to characterize and predict disease progression, to determine prognosis, to guide treatment strategies.
Stages of liver disease
Fibrosis score:
F0 = no fibrosis
F1 = portal fibrosis without septa
F2 = portal fibrosis with few septa
F3 = numerous septa without cirrhosis
F4 = CIRRHOSIS scarring of the liver - hard non-functioning scar tissue replaces soft healthy tissue.
Cirrhosis of the liver is the stage or a measure of the degree of liver damage caused by various liver diseases. Such diseases as alcoholic liver disease, chronic hepatitis B or C infection, fatty liver disease, autoimmune hepatitis and well as many others can lead to cirrhosis usually over many decades of disease.
Please follow up with your doctor to learn more about any liver disease you may have and the extent of your liver disease. If you have cirrhosis of the liver we can help you to learn more about how to best manage your cirrhosis.
Good luck to you.
Hector
A positive result does not confirm a disease; it is used in addition to signs and symptoms, specific antibody tests, and liver related tests and imaging findings, such as ultrasound, CT or MRI findings. Treatment may be needed depending on the findings of your medical work up.
Like all liver diseases, the extent of the disease can very widely. Some people can have little liver damage and no signs of their disease while others can have extensive liver damage to the point where they liver can no longer function properly and they will need a liver transplant to continue living.
Scoring systems for chronic liver disease are used to characterize and predict disease progression, to determine prognosis, to guide treatment strategies.
Stages of liver disease
Fibrosis score:
F0 = no fibrosis
F1 = portal fibrosis without septa
F2 = portal fibrosis with few septa
F3 = numerous septa without cirrhosis
F4 = CIRRHOSIS scarring of the liver - hard non-functioning scar tissue replaces soft healthy tissue.
Cirrhosis of the liver is the stage or a measure of the degree of liver damage caused by various liver diseases. Such diseases as alcoholic liver disease, chronic hepatitis B or C infection, fatty liver disease, autoimmune hepatitis and well as many others can lead to cirrhosis usually over many decades of disease.
Please follow up with your doctor to learn more about any liver disease you may have and the extent of your liver disease. If you have cirrhosis of the liver we can help you to learn more about how to best manage your cirrhosis.
Good luck to you.
Hector
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