Autoimmune hepatitis

[Margot49]

I have been having ongoing problems for over 5 years with no diagnosis after numerous testing.
I have had elevated Alk Phos for a long time.  Went up to 169 then 144 last test.  My GI doctor also said I have a marker for autoimmune hepatitis, which I don't understand.  Some of my other blood work is elevated also.  He has ordered more follow up blood work to be done next month.  He almost casually mentioned a liver biopsy!!  I have tried to research this some but still don't understand it much, ESP the lab values and at what point are they considered high??  I also read that people with Type O blood, which I have, can have higher Alk Phos.
I have suffered from chronic dry mouth and throat (2 biopsies Neg for Sjorgens), had major GI problems last year ( long story you can read in my other posts),  night sweats or waking up clammy and nausea which I now somewhat control with acupuncture and ginger and honey.  I keep telling the doctors I have seen that I just don't feel well.
Any input?  I sure as heck don't want a liver biopsy!

[jbeckett92679]

nutrition has a lot to do with this as well.  have you tried changing to a blood type or genotype diet? It helps regulate insulin, liver function, soothes the GI and makes great sense. Dr. Peter J. D'Adamo has a book out called "eating right 4 your type" and it has helped me greatly.  I have an undiagnosed autoimmune as well, and I notice less symptoms when I eat on this diet.  anything is worth a try, and if it helped me, it might be able to help you too, naturally, with no drugs.

[Margot49]

Thank you for the response. Checking my past labs of Jan, 2013 I see

C4 Complement ADULTS: 16-47 mg/dL 15

Actin Antibody IgG 53 H
Reference Range:
OR = 20 POSITIVE

Antibodies recognizing actin are the main component
of smooth muscle antibodies associated with
autoimmune liver disease. Actin antibodies are
found in approximately 75% of patients with
autoimmune hepatitis (AIH) type 1, approximately
65% of patients with autoimmune cholangitis,
approximately 30% of patients with primary biliary
cirrhosis, and approximately 2% of healthy people.
High values are closely correlated with AIH type 1.

Gastric Parietal Cell Ab 28.9 H
Reference Range:
=25.0 POSITIVE

Anti-gastric parietal cell antibodies (Anti-GPA) were previously
tested for by indirect immunofluorescence (IF) using mouse stomach as
a substrate. Identification of the specific antibody target as H+/K+
ATPase protein (a gastric proton pump) has led to the development of
an ELISA based assay. Antibodies to this protein are present in
approximately 80% of patients with pernicious anemia and a small
percentage of the general adult population. The latter percentage
increases with age and may reflect the presence of atrophic gastritis.
A negative test does not exclude a diagnosis of pernicious anemia. A
test for intrinsic factor blocking antibody (IFab) may provide
serological evidence in support of the diagnosis in some of these
patients.
Reticulin Antibody IgA Negative Negative
Reticulin IgA titer SEE NOTE
TNP-Screening test Negative or Not Detected. Titer not performed.
ANTI-DNA (DOUBLE STRAND) Negative Negative
ANA Titer SEE NOTE
TNP-Reflex testing not required.
Anti-Striated Muscle Ab Negative Negative

There are numerous other tests.  I do have osteoporosis.  

I really don't understand what these tests mean

[Dr. Kokil Mathur]

Hi!
I am sorry to hear about your medical problems. Chronic dry mouth with GI problems can be due to GERD along with H pylori infection. So this should be investigated for. Take Omeprazole empty stomach in morning and an antacid gel at bedtime. Refrain from smoking, alcohol, fuzzy drinks and spicy food.
On net it is very difficult to determine whether you have autoimmune hepatitis or not. For diagnosis you need to get liver function tests which will be grossly abnormal. Liver biopsy will show chronic hepatitis.  Presence of anti-liver kidney microsome type 1 antibody (anti LKM-1), anti-nuclear antibody (ANA), anti-smooth muscle antibody (ASMA), and serum IgG confirms diagnosis. So these blood tests can be done before the biopsy.
Alkaline phosphatase levels of 169-144 etc should not be a cause of major concern, unless other liver enzymes are grossly abnormal. An elevation in AP is often seen in cholestatic liver disease, pregnancy, bone disease, and occasionally with inflammatory bowel disease (possible in your case).
Please consult your doctor regarding this information. Take care!

The medical advice given should not be considered a substitute for medical care provided by a doctor who can examine you. The advice may not be completely correct for you as the doctor cannot examine you and does not know your complete medical history. Hence this reply to your post should only be considered as a guiding line and you must consult your doctor at the earliest for your medical problem.