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Blood results - smooth muscle?
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Blood results - smooth muscle?

Hi all
We've finally seen a hepatologist!!! The dr ordered a full blood panel and will review it when we see him in 3 weeks time, he will also do a fibroscan the same day.

We've already seen the results of the blood work (still waiting on the viral
count)  and everything looks normal except
the smooth muscle test which we don't understand and would love for someone to
interpret it for us.

Here is some background info. He has HCV genotype 1 and diagnosed about 17 years ago, no other health issues. The smooth muscle blood test results are as follows:

Smooth muscle ab .... A POSITIVE
Smooth muscle ab titre .... A 1:80

Now, what does that mean? 3 weeks is a long time wondering. Does this mean he has some internal damage such as cirrhosis?

Thank you all for your time
18 Comments Post a Comment
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Avatar_f_tn
It has to do with "Hepatitis Autoimmune".   "medicalhealthtests.com" gives a pretty good explanation.  It looks like you will be retested to confirm the test in 2-3 weeks.  You can also ask question at the "hepatitis autoimmune forum".

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I agree with happy again, but wanted to add that it doesn't mean anything at all about damage to your liver, it is strictly a test for determining disease causes, not for measuring effects.
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Avatar_m_tn
It is not uncommon for Hepatitis C patients to test positive for anti-smooth muscle antibodies. I wouldn't get worked up about it at all.

Mike
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Avatar_f_tn
thanks. i just wasnt sure if this was another thing to worry about....as if the hep c isn't enough to worry about now he has to worry about a possibility of AIH.  he was on an antibiotic about 4 days before the blood was drawn, i'm wondering if that can produce a false reading/test....because all his other levels fell within a normal range. i'm just happy that he finally having someone look into his disease for the first time in 17 years.....hopefuly the fibroscan will give us some more answers on the disease progression.
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Avatar_m_tn
           glad you have a hepatologist to sort out this puzzle.  another person on this site has hep c and aih.  the problem is the meds for aih are terrible for hep c.   but its doable
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Auto-immune disorders do pop up with some frequency in hep c patients. My initial hepatitis diagnosis in 1986 came after I had a battery of tests to try to figure out what was causing severe and sudden joint pain in my hands. In the end the theory was that it was an autoimmune response triggered by a reaction to the virus - but it was many years before that conclusion was reached. In my case it was anti-nuclear antibodies that came up positive, something that is normally associated with lupus, except I've never had other signs of lupus. I don't know what kinds of problems might be associated with anti-smooth muscle antibodies, or if your titer is high enough to be significant, but you should ask your doctor for clarification. It probably isn't worth worrying over, but it still warrants learning more.
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Avatar_m_tn
"Interpretation

Negative titers for anti–smooth-muscle antibody (ASMA) are expected in healthy individuals. Positive titers indicate the presence of several underlying conditions, including the following:

    Autoimmune hepatitis type 1
    Hepatitis B
    Hepatitis C
    Primary biliary cirrhosis
    Primary sclerosing cholangitis
    Overlap syndromes

The degree of positivity evidenced by the titer can be used to determine the etiology. Such an approach is especially useful for correlating ASMA positivity with the presence of autoimmune hepatitis, specifically type 1.[3]

In 1999, Alvarez et al developed a scoring system for autoimmune hepatitis type 1 (AIH-1) in which a negative titer yielded 0 points, a titer of 1:40 was 1 point, a titer of 1:80 was 2 points, and a titer of ≥1:80 was 3 points.[1] A definitive diagnosis was determined by a score of >15, while a score of 10-15 indicated a probable diagnosis of AIH-1.[1, 2]

In 2008, Czaja created a scoring system that was simplified from the previous version and proposed that ≥1:40 was 1 point and ≥1:80 was 2 points.[2] In the new scoring system, a definitive diagnosis is ≥7 and a probable diagnosis is 6.[2]

A positive result can also be found in patients with chronic hepatitis B or C.[1, 4, 5] In such individuals, positive hepatitis serologies indicate viral hepatitis as the etiology. Additionally, ASMA can be positive in primary biliary cirrhosis, primary sclerosing cholangitis, and overlap syndromes associated with AIH-1.[1, 3]........"

http://emedicine.medscape.com/article/2086774-overview#aw2aab6b3

"Approximately 40% of patients with chronic hepatitis C infection have a positive ANA or ASMA, usually in low titer. Elevated smooth muscle antibody titers have also been reported in a small number of patients with viral hepatitis, infectious mononucleosis, malignant tumors, alcoholic cirrhosis, and 5% of normal patients....."

http://www.clinlabnavigator.com/smooth-muscle-antibody.html
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Avatar_f_tn
1:80 results can be a false positive.  That why your retesting in three weeks.  
I would wait for those results to confirm if you do indeed have to worry about this.

DWBH
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Avatar_f_tn
is 1.5 on reticulocyte count good?then  smooth muscle ab igG titer 1:20.dr just said it was lookin like i had AIH til biopsy was done.i just feel something is being missed my side shouldnt hurt me everyday.i take care of myself sorry just venting tired of ppl (dr's) saying i look like a million bucks and thats it.my liver dr seemed like she had too many pts.in my opinion.but i dont live her life she was kind and nice but not effecient,i have found out more info on medhelp than w/ her.best of luck i hope you are satisfied w/ yours,i am not happy w/ mine cause of it just seemed like she's got too many of us.
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Avatar_f_tn
Thanks everyone for the feedback. This site is so helpful. We are hoping that it's false positive which I'm thinking might be due to the antibiotics?!
Thanks again.
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Avatar_f_tn
I saw you posted to my question and I wanted to let you know what my specialist had told me today after my appointment since your post was pretty identical to Myne.  So I had a fibroscan done and with all my bloodwork and recent ultrasound results it looks as if I have minimal damage we are still doing a biopsy to confirm but in regards to the smooth muscle ab positive my titer was 1:100 and yours being 80 he said it wasn't uncommon to find that in an active chronic hep c infection. My bloodwork diddnt support the fact of autoimmune hepatitis...huge sigh of relief.  Hope this helps I am a genotype 1 a and have been infected 27 years from a blood transfusion at birth. Wishing your husband all the best :)
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Avatar_f_tn
Thanks so much for this info. We are located in Canada so I am not sure if the numbers are reported differently.... Does 1:80 mean 80? His returned back as 1:80 here in Canada, is that Considered high? And can that number decrease over time...or increase?   We don't see the hepatologist for another 2 weeks where he will have a fibroscan done. He's a genotype 1 and been infected for 17 years.... He also smokes quite heavily, at least a pack a day. I read that smoking increases chances of liver cancer so
I'm worried he'll have some damage. His blood work looks good and his ultrasound only showed a few gallstones. But not sure how accurate an ultrasound is anyways. Do you plan on treating now or in the future?
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Avatar_f_tn
I am in Canada aswell BC, I am a smoker for 10 years about 15 a day give or take. Smoking increases a risk for a lot of cancer so quitting would be ideal but I know how hard that can be when u have stress and other things going on. My titer was given to me as 100 so I don't know about that but my specialist Said it wasn't high to suspect auttoimune hepatitis yours being lower than Myne would have I'm sure the same results. Ultrasound results won't show you damage just I think more if there are spots on it or enlargement ascites etc. Myne came back completely normal on everything pancreas,liver,gallbladder,kidneys, etc i do have a bit of scarring nothing major which if I clear this virus I'm sure could be reversed over time. I am not going to treat right now gvt won't fund any of it for my liver enzymes are in normal range and I want to try and get in a trial of newer Meds and my doctor supported that for me too. If situations arise that tell me differently ill take it step by step . For now I'm going to monitor and biopsy and enjoy my 2 beautiful girls :) new baby now 5 months old and a 4 year old means treatment with incivek would be a lot for me with 2 young children. Also my new daughter was born with a heart defect so my focus right now is on her and getting all her cardiologist appts on the go and make sure she is doing ok :) keep me posted as to how your appointment goes it seems your thoughts and situtatiom are exactly like Myne :)
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Thanks! We are located in Vancouver and it seems that treatment isnt easy to get here. We'll be asking about trials the next time we go in.  Good luck with you and your little one!
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Thanks :) yah I know it's a bit different in Canada compared to the states I'm in vancouver too... Where are you going? I'm at the laire center
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Avatar_f_tn
Same here!!!
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Small world
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One question I forgot to ask the doctor was how accurate a fibroscan was in determining fibrosis... You may want to ask that :)
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