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elevated autonuclear antibodies in AIH

Posted by donald on May 26, 1999 at 10:10:12
This is a follow-up to my earlier posting of April 24.  My wife's gastroenterologist told us today that highly elevated ANA levels can occur with autoimmune hepatitis even though enzyme levels are almost normal (about 50). My research in Medline has failed to locate any published reference to this.  The ANA level has risen from 1:640 last August to 1:2560 this March.
Your comments would be appreciated.

Posted by HFHSM.D.-D.M. on May 31, 1999 at 16:51:43

Dear Donald:
I appreciate your follow-up correspondence.  Your gastroenterologist is correct in that an individual can have autoimmune hepatitis with a markedly elevated ANA and only have mild elevations of the ALT and AST.  While the ALT and AST are usually good markers of disease activity and we monitor them to assess disease activity, in a minority of patients they do not correspond well to the severity of disease.  For this reason, we often find a liver biopsy is helpful in sorting things out and establishing both the diagnosis of autoimmune hepatitis and the severity of disease.  
It is hard for me to point you to a specific reference.  Probably the best thing is for you to check out some of the liver disease textbooks which you can get any medical school library.  I would recommend
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