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Autoimmune Hepatitis - anti smooth muscle antibody...
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Autoimmune Hepatitis - anti smooth muscle antibody...

Hello all...i'm a 24 year old male (skinny/normal lipids) who has fluctuating ALT since Nov. 2003, In late August i started taking Restoril for sleep and then had a blood test 3 months lsater in Nov. when the high enzymes showed up...my highest ALT was 132 and highest AST was 61. on Nov. 28, 2003 the ALT was 101 and AST 61 which drew the doctors attention...since then i've monitored it regularly and it has gone up to the max of 132 on April 1 and the ALT has stayed around the 17-40 range..the ALT is usually around 83-92 range, but has also gone down to as low as 41 on one occasion. i've had 2 normal ultrasounds, a normal mri and mrcp of liver, and normal hep a, b, c, normal for hemochromatosis, wilson's, normal gamma globulin and normal serum electrophoresis, normal for celic sprue, negative ANA..THE ONLY positive thing that has showed up has been a slightly positive Anti Smooth Muscle Antibody..In December it was 1:40, and just last week in June it went up slightly to 1:80.  My ALT was at 88 and my AST was 37 at that same time last week.  
Does anyone think this sounds like Autoimmune Hepatitis?  the hepatologist i see set up a Liver Biopsy for July 8. But he said usually people who have AIH have higher ASMA than i did.
  Also, is the Liver Biopsy difficult?  He said he's done over 3,000 in his life, but he uses x-mark the spot w/ an ultrasound.  However, i was confused whether i should go with this route or go w/ the Intervential Radiologists who use the guided ultrasound the entire time?  thanks for all your suggestions, ideas, help, etc.  Best of health to everyone.
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9 Comments Post a Comment
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Avatar_n_tn
thanks for the reply...actually, my December titer of 1:40 is LOWER than my June titer of 1:80....anything between 1:40-1:160 is a positive but not always associated w/ AIH...anything above 1:160 is strongly indicative of AIH.  the tighter starts at 1:20 so 1:40 is barely positive.  take care:)

alex
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Avatar_n_tn
Your June ASMA (1:80) number is actually a LOWER amount than your December number(1:40).  My ASMA numbers have been around the same range as yours, and despite my concerns, my GI's (two of them), don't seem particularly worried.  Neither of the believe that I have autoimmune hepatitis in coexisting with my viral HCV.

Susan
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Avatar_n_tn
I think one of us is confused about how to read those numbers.  It's my understanding that they are a ratio.  So 1 part to 32 is MORE of the antibody than 1 part to 80.  At least that's how my GI explained it to me.

Susan
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Avatar_n_tn
hey susan, here's a good think that explains it somewhat...the positive titers usually starts at around greater than or equal to 1:40 (which is very low)...

http://www.palpath.com/asma.htm

best

alex
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Avatar_n_tn
I've been dealing with Autoimmune Hep for about a year now.    For whatever it means, I would also suspect AIH with your symptoms / tests results.  But please don't panic.  (I've been where you are and it is scary.)  If it helps you any to know ... I've been as high as ASMA 1:1240  ALT 2515  AST 1325   and I'm doing good now.  God is good.  Have faith.
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Avatar_n_tn
Do you get outrageous leg cramps at night with higher liver function levels?

I have had chronic hepatitis for 18 years since I had hep B but I do not have chronic hep b. It gets bad when I have had steroids but the worst part is the excruciating leg cramps at night. They are not real leg cramps because they never hurt the next day but they are far more painful then the cramps that hurt for days after.

I had a bad night last night and today my legs have been twitching all the way around both calves. It was very intense this morning and occasional this afternoon. You can actually watch all the muscles firing randomly. Its not painful but absolutely bizarre.

My ASMA has always been low when checked during acute episodes. I do not understand ASMA and why I have cramps when its low and not high. My ANA has always been normal.
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233616_tn?1312790796
somebody sure likes to invent threads and then talk to themselves.....

rolleyes.
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Avatar_n_tn
Hi there, I have a question to ask.  My girlfriend has had Narcolespy for a year(diagnosed).  They put here on a med and rose her scores to the ranges you are talking about on this board.  She just got back her latest score and there hasnt been any change in a month still around 120-130.  They sent her some paper work today about what it could be, and the Hep. is one of them.  She test neg. for A,B,C, but they said it could possibly be this type.  We are both going nuts, im scared out of my mind, what are some things to look for, to help figure this situation out
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Avatar_n_tn
I was just diagnosed with a positive smooth muscle antibody.  The ASM Titer was 1:20.  I am not sure what all of this means.  Reading some of the comments above, they are higher than mine.  I am supposed to be tested in 3 months.  Any thoughts on this?  Thanks
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