So, if life with the fear of facing my newly identified disease isn't already confusing, I had my biopsy last week and received inconclusive results Monday. Based on elevated LFT's, AMA, and high IGM (but not elevated ALP), my doctor ordered the biopsy to get a clearer picture of my 'probable PBC'. The biopsy came back unclear of PBC though "some portal tracts appear to be missing bile ducts,and there is mild portal fibrosis". The doctor spoke to the pathologist to get a better understanding of the written report which references "findings suggest a component of AIH...however an overlap between autoimmune hepatits and primary biliary cirrhosis cannot be completely excluded. Features of primary biliary cirrhosis are not identified in this sample, the findings are relativly patchy and clinical correlation with appropriate laboratory findings is recomended". He's as dumbfounded as I am, as I don't have ANA or ASMA markers for AIH and it all clinically leans to PBC. I know the samples were small slivers and it is anyone's guess whether it is representative of my entire liver. Anyone have this happen to them?
I also questioned whether I should start meds and he would like to wait three months to make a more appropriate decision on treatment, especially since the word 'mild' was used several times in the report to describe findings. He explained that with the recent dietary change to GF, a 24 pound (nearly 2 stones?) weight loss, clearer skin, etc., that inflammation is clearly leaving my body and four LFT blood work ups have proven this with AST/ALT dropping almost two-fold. He would like my weight and labs to stabilize so he can look at baseline numbers and determine whether URSO, a low dose of Prednizone or both should be administered. He fears putting me on med too quickly will disguise the change my body is going through with the diet and we won't know if the meds are dropping numbers, or if being GF is helping to drop them. I am wondering if any of you have ever experienced a delay in treatment or perhaps a change in direction after a biopsy? Thanks!