Follow up on AMA positive.

[Jacques66]

Hello again,

I had written to you before in regards to my AMA antibodies being positive. And today I got the titer it's 1:640. About me, 44 yr old female, in good health except Hashimoto's and on 75mcg Synthroid. My liver ultrasound was all ok, and the hepatic panel all normal except ALT is 45 (very slightly high). My hepatologist at USC is not alarmed, he wants me to do 2 other tests: AMA M2 and Bile acids/salts tests. He also checked IgM 142, IgG 1201, and IgA 152. I am still worried about the PBC possibility, and I wanted to ask you about my titre level if it's very high or not.

Thank you again!

[Thomas D Schiano, MD]

the AMA titer is high. the IgM titer is usually (+) in PBC.  You could have very early PBC--with a normal alkaline phosphatase i do not think i would obligate you to starting lieflong actigall.

[Thomas D Schiano, MD]

There was some glitch in the system so I am just now receiving your question--sorry for any delay.

Taline, I think that this is still within the normal range and I am not concerned.  continue everything that you are currently doing--except worrying.  Enjoy the holidays.

[Jacques66]

Dear Dr. Schiano,

I just had a follow up visit with the my hepatologist in regards to additional tests he had recommended AMA M2, Total Bile Acids and LFTs tests. The LFTs were all normal again, Bile Acids was 15 (ref. range 0-19) and AMA M2 was positive just like the AMA. Just like you said earlier, he also said that I am in preclinical stage and there is no need for a biopsy or Urso, and will be following up with me every 6 months.

My question is that after reading about Total Bile Acids range, I realized mine is high regardless of being within the range on my lab sheet. Do you think 15 is a significant range for an abnormal flow of the Bile Acids?

I would really appreciate if you could shed some light on my question.

Also, my family and I would like to wish you a Happy Thanksgiving. You've been a tremendous help to my mom and me in the last 2 years. Thank you, thank you, thank you.

Taline

[Thomas D Schiano, MD]

the IgM seems to be in the normal range.  i do not think a liver biopsy is warranted as it probably wouldnt show anything except nonspecific findings

[Jacques66]

Thank you for responding so promptly to my question. Is my IgM in range? because, I don't know what the range is for that. And also, is it too early to have a liver biopsy in my case?