1952776 tn?1325606457

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.


Like I said I've had liver stuff off and on but I'm just not sure.  Thanks for all your help.
4 Responses
1756321 tn?1547095325
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
434278 tn?1324706225
Welcome to the forum.  So sorry to hear about your health problems.  

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

1952776 tn?1325606457
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.
1952776 tn?1325606457
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.
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