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AIH and PBC - Statin Question
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AIH and PBC - Statin Question

I got the results of my liver biopsy and am still trying to digest the bad news. I have Autoimmune Hepatitis and probably also have Primary Biliary Cirrhosis. The hepatologist said that I have both of these diseases and that he would speak to the pathologist to determine which one is the primary process, whatever that means. Does anyone know why is it so important to know which one is dominant?
The report states that I have grade 2 of 4 chronic hepatitis with rosetting, focal plasmacytosis and rare focus of lymphocytic cholangitis. Stage 0 or no fibrosis. No stainable iron, copper or a1at globules. The histological features are suggestive of autoimmune hepatitis. With focal lymphasitic cholangitis, there is a potential component of PBC. However, this needs, serological, clinical and LFT correlation.
The hepatologist said that the course of action is to watch my liver enzymes, testing every 3 months.  If my AST or ALT rise to the 200 level, he would put me on Predisone and another drug.
Also, now that I have been off my statin for a couple of months, my cholesterol is in the mid 300s.  He said that I don't need to restart my statin because these higher cholesterol levels do not contribute to heart disease in someone who has these two liver diseases.  Does anyone here have high cholesterol along with liver disease and not taking a statin?
Lastly, I was told that I should drink a lot of coffee and give milk thistle a try.
I am making an appointment to see a doctor for a second opinion at the Hepatobiliary clinic at Mayo in MN.  Until then, any suggestions?  Is there a good book out there that will help me learn about these diseases? I have been reading a lot lately, but just pieces here and there.  I would be great to find a good resource in one spot.
Oh, I guess its time to move to a different forum, I will post this in the cirrhosis forum as well.
Thanks so much!
Lisa
517301_tn?1229801385
it is important to know if you have an overlap syndrome as the PBC component will respond to the use of actigall whereas the autoimmune hepatitis component will respond to prednisone or azathioprine.  The biopsy slides should be reviewed by an expert liver pathologist as it can be difficult to differentiate between PBC and the overlap syndrome.  The elevated cholesterol can be due to having PBC--statins are OK to take as is milk thistle. PBC doesnt progress quickly whereas autoimmune hepatitis can.
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Thank you for your quick response.  I have an appointment at the hepatobiliary clinic at Mayo in Rochester for next Monday.  I have requested that the pathology lab send copies of my liver biopsy slides to Mayo. I hope the doctors at Mayo will be able to determine what and how many processes are involved, and which one is dominant.  I am assuming that the course of action will be determined by which process is dominant.  Is this correct?  
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517301_tn?1229801385
this is correct.  good luck with your appt
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Thank you for responding.
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Thomas D Schiano, MDBlank
The Mount Sinai Medical Center
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