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Does anyone know much about AIH? Is it possible to have AIH and a normal LFT?
Hey everyone,

I'm seeking advice here as everything has been happening so fast that I don't know what to think or what to do, and want to make sure The proper precautions have been taken.  So in very late March I had to be hospitalized because I was having really bad abdominal pain in my upper right abdomen under my rib cage. Plus I was passing some dark urine. The doctors decided to check my liver function and my (Alk Phos:274, AST: 89, ALT: 174, ESR: 74) were elevated. So was my pancreas enzymes (Amalayse: 116, Lipase:69).  The doctors told me I had non viral hepatitis. My viral hepatitis tests came back negative. The hospital also told me I had "mild jaundice" but I didn't look yellow or have yellow eyes. Anyway, while there the doctors gave me an ultrasound. Everything looked normal. No gallstones or anything. The doctors decided to test me for some autoimmune conditions. I came back positive for this SMA (Smooth muscle antibody test) and everything else was normal. After being there for a few days and rude bedside manners of the doctors I thought it was time I seek a 2nd opinion. I followed up with my Main doctor who retested my LFT and antibodies. My liver function was still elevated and my GGT was in the 300's, but to her something still wasn't adding up because my titer for the SMA was only 1:40 and so with my blood work should correspond with the titer. So I had to seek a 3rd opion. By the time I got to the 3rd doctor ( Now in April) which was like 3 weeks Later and affiliated with a more credible hospital my LFT had returned to normal and I was no longer testing positive for the SMA.

However, Another week or so after everything coming back normal (Now in May)  I was still having abdominal pains. So he rested my liver again and sent me for a CT scan. My abdominal CT scan came normal and my LFT is fully back to the normal range I'm use to. However, he checked my pancreas Enzymes and noticed my lipase is mildly elevated and that could be he source of my pain. After changing my diet the pain did ease up. However, it's still mildly there, by not as constant as before.

I'm still having mild pain in the right side of my abdomen under my ribcage, but everything is still showing up as normal in my bloodwork and I'm no longer testing positive for that SMA. I asked my doctor why that is when I was testing positive before and said it could have been a "false positive" the whole time and what I really happened was I caught a virus the whole time. I guess my real question is did anyone with AIH go through a similar problem? Did I take all the necessary precautions? When I was at the hospital they did mention a liver biopsy to me, but they said that was very last option because the GI specialist wasn't "convinced" that's what I had. The GI specialist believed it really could be a virus or a UTI (they I tested positive for) that caused my LFT to seem whacky. Should I still be concerned about the possibility of having AIH? I've read some stories where ppl's liver function returned to normal randomly and then BAM it came back with a vengeance one day or months later and it was full blown AIH. I'm very worried! Also two prior before being hospitalized for the abdominal pains I had gotten a tetanus booster and was wondering if that's what caused my liver function to go whacky temporarily. I did mention it to my doctors. One doctor said it could be a possibility and my current doctor said its "highly unlikely". He's never heard of it. In my mind I'm thinking Drug companies don't report everything. Mind u the whole time I had elevated liver function no doctor gave me meds to treat it. Is it normal for antibody titers to just "go away".?
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Also, I just wanted to add this is a repost and was just seeking more opinions on the matter as this annoying dull ache under my right rib doesn't seem to want to go. It hurts a bit when I do sudden movements.
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Yea, antibody levels can fluctuate and even disappear. Getting your liver panels retested every 3 months or so, just to see if a recurrence happens. If it does, then a liver biopsy maybe needed to clarify things. But your doctors will need a little more suspicion before they are willing to take take risk. If you do have AIH, your numbers will go up again, sinply a question of when.
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