anti smooth muscle antibody

Anyone know what this is? I received the blood test reports from the rheumatologist but have not yet seen him. The lab sent the results to me as well as to him. He did a tremendous amount of blood work and all was negative except this 'anti smooth muscle antibody' which was positive. I see him in 3 days, but I guess I like to be prepared for what he is going to tell me.

I looked it up on the internet and it says something like it could be autoimmune hepatitis.

15 Replies

  • I have that too. It seems to be a non-lupus antibody against the liver. Since non of my liver tests are abnormal, no one seems very concerned about it, so neither am I.

  • Does it have anything to do with APS?

  • Like they say, I'm not a doctor, but it seems to be its own autoimmune disease. Sorry, I forgot which community I was in when I wrote this answer, but there is autoimmune lupus, which this isn't. As far as I know it doesn't have anything to do with APS, either. But if your liver numbers are normal, apparently, you don't have to worry. I've talked to both my PCP and my rheumatologist, and they pretty much shrug their shoulders. If you ever go to a gastroenterologist, you might ask them. I figure if I turn yellow or I see any scary number on my liver numbers, I'm not worrying. I've got enough on plate.

    Sometimes, these things are one time deals, anyway.

  • I guess I will get answers from the rheumatologist on Monday.

    One thing I thought of and I have to ask him--I was on the antibiotic Keflex for an infection 3 weeks before the blood work was done---In the past, I got drug induced hepatitis twice after taking the antibiotic Erythromycin--the first time I got it, they didn't know what caused it and it wasn't type A,B, or C (non-contagious).--was sick for 6 weeks with it. Then 4 years later, it happened again and they determined it was from the Erythromycin (it lasted about 4 weeks)

    --the liver doesn't process it in some people. both times with no residual effects--my liver numbers have been fine since.

    thanks for your input.

  • If you are having problems with your liver, definitely ask him about it.

    I don't know if sometime down the line, I'll have a problem, but so far it seems I'm OK.

    I did read there is an autoimmune hepatitis that isn't lupus.

  • This does crop up with Hughes Syndrome/APS and also Lupus, plus in other areas, I enclose a slightly wordy link that you may find of use:


  • Hi Mary

    I went on the website you recommended--some of it confusing, some scary........but I did read most of it.

    I saw the rheumatologist this past Monday and he went over the results of all the blood work. Everything came back negative, except, the test that came back positive for Smooth Muscle Antibody---and yet, ironically, he said he never ordered that test. But for some reason, the Lab did it--perhaps it had to go along with other tests he ordered. Now he says he has to follow through because it came back positive.....So he is sending me for more extensive blood work.....It has to do with the liver --autoimmune hepatitis---but he said my liver enzymes were good--but he still has to follow through--it has really shaken me up a bit. I told him about the reaction I got from Erythromycin twice many years ago (getting drug induced hepatitis)...I also told him that three weeks before he did this blood work I was on Cephalaxin (Keflex) antibiotic for an infection in my leg and is it possible that it caused problems with my liver as the erythromycin did. He said he can't really say, but he must do more tests.

    So here we go again........

  • Jeez, now I wonder no one had to follow up with me, but the doctor I trust the most wasn't worried, so I guess I'll just forget about it.

  • Hi Ann

    I believe my doctor has to follow up because it's the first time he has seen me, and he has never treated me before for anything. He just has the medical records and copies of tests I brought with me. And if this turns out to be something serious and he hasn't followed through, well...........But I'm hoping that it turns out to be nothing.

  • Let us know what he says. I will be interested to know.

  • Thanks Ann,

    I had the blood work this morning (Tuesday), and I think it takes at least a week to process in the lab. The doctor said he will call me when he gets the results.

    Anxiously waiting..............................

  • I haven't gotten the results officially from my doctor, but the nurse who drew the blood from me called and said the other tests he did--anti-mitochondrial antibody, and anti reticulin IGA and IGG came back negative. I guess he still has to call me to go over it all with me and 'put to rest' the issue of the smooth muscle antibody positive test.

    But looks good :)

  • It seemed like so out of the blue for me. I'm glad it is being put to rest.


    My rheumatologist called me this evening and said that the additional blood work he did--anti mitochondrial antibody and anti-reticulin lGA and lGG that he tested me for after there was a positive for anti-smooth muscle antibody which relates to autoimmune hepatitis, are negative. Based on the fact that my liver enzymes were in range, he feels leave it alone for now. He is going to repeat the anti-smooth muscle antibody test in 3 months--if negative, then no more testing. If positive, then I would have to see a gastroenterologist. Wow, that's one doctor I haven't seen yet. :)


  • Glad that's off your list of concerns. I think I'm just letting it all go. If my liver starts acting up, I'll remind them of the anti liver antibody--that is if I can remember I had it.

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