My AMA test was positive.

[Jacques66]

Dear Dr. Thomas
I am a 43 yr old female with Hashimoto's disease and on synthroid 50mcg. It's been a year that I've had itching in my palms and no matter how many different cortisones I used, my palms are still red and itching. Saw 2 different dermatologists and one told me eczema and the other psoriasis. My PC ran many tests, and my hepatic panel is normal, my anemia profile is in range, all my chemistry numbers are ok, eosinophils high. I have vitamin D deficiency and B12 borderline, and tested positive for AMA antibodies 107.
My mom wad diagnosed last year with drug induced autoimmune hepatitis, and you helped us a lot months ago. I understand high level of AMA is related to PBC and I was wondering if you can give any advice on that. Also, could Hashimoto cause AMA to be positive too?

Thank you so much

[Thomas D Schiano, MD]

frankly don't think you need see a hepatologist as the liver tests are OK.  you can check an IgM level, which is also frequently elevated in PBC.

[Jacques66]

Dr. Thomas,

Thank you for your prompt response. On my lab result, there is no titer range, only reference interval of <20 for AMA negative and my range is 107, so I don't know if I should call the lab and ask for the titer. Do you think I should be seen by a hepatologist?  We take mom to USC and BTW she's doing fine, all her liver panel #s are normal now.(She was the lady with the lipitor induced auto immune hepatitis case).

Thank you again

[Thomas D Schiano, MD]

hashimoto's is definitely associated with autoantibody formation.  low titer AMA is possible (1:40 or less).  remember that hasimoto's can also be associated with PBC as can eosinophilia and pernicious anemia (low vit b 12).  if the liver tests are Ok then there is nothing to do for now but this could be very early PBC.  what is the titer of the AMA?  you should check a bone density test.