Test results confusion

[hgreen]

Hi,

Please could someone help me understand my recent blood results! I've just got a copy as have been advised to keep copies from now on ( only recently diagnosed!). I'm aware that alkaline phosphatase and alanine transaminase are expected to be raised. My IGG and IGM is also raised. Is this to be expected with those of us with pbc too?

[Hidden]

Hello hgreen.

I started to ask for my blood results in a print out at diagnosis due to having a Vitamin D test I wasn't aware of. The hospital consultant had wrote in his letter to me that he was diagnosing PBC - I was diagnosed via symptons, higher than normal LFTs (liver function test) and GGT blood test plus I was itching (reason saw a GP originally) - my Vitamin D levels were 'a bit low'. I didn't know what that meant so I rang his secretary and she said she'd send me print out of the bloods I had during 2010 (I was diagnosed with PBC December 2010 after going to see my GP March 2010). I wanted a figure so I could see what it meant. I noticed on seeing print out that the Vitamin D was 'on the line' and the consultant although he said his terminology, he wasn't at the time recommending any supplements.

It is normal in PBC to have higher than normal LFTs which consist of several different blood checks. With urso that we take they are expected to start to drop and in some cases they can return to normal (mine haven't but they have dropped over time) but we are not actually expected to have normal LFTs and there is some leeway with our bloods as opposed to someone who hasn't got a liver issue.

My ALP and ALT as the ones you are referring to tend to both swing up and down when I have them checked. The GGT (you refer to them slightly differently but it seems that we all tend to get variable terms and also the figures can vary. Mine have a different figure reading but mean the same due to which laboratory checks them.

I only request a print out of my bloods each time as I have found for me being informed that 'this patient is OK' on my repeat bloods is not acceptable. I think in having PBC a lot of us prefer to see the figures. The thing is though seeing the figures after being on urso for a spell they can start to look a bit like they have slowed down but I think it is quite normal. Mine started off dropping rapidly in the first 6 months of taking urso but then started to slow down.

I am in the UK and have found having the repeat bloods taken can be the more stressful, not the actual results but the battles I've had with the GP surgery to give them to me....hopefully that will be a thing of the past now that our medical records in basic terms are being put online for patients in the UK who are registered for online appointments and also requesting the urso as I do. I noticed my medical records and past blood tests for the PBC are online so I can see for myself but I think it would still require a GP checking them over first before they are. I've no problem with this as I always ring the surgery regardless each time and like to check the print out as for me I've had the GGT one missed several times since diagnosis and the last time I had blood checks notso long ago it was missed again.

[GrittyReads in reply to Hidden]

Hi Peridot,

According to my online checks, GGT is quite different to IGG and IGM.

I remember having trouble finding out about IGG & IGM a year or so ago, after someone on the site had mentioned them in a post. However, now, it seems there is more info available.

[Hidden in reply to GrittyReads]

Hello GrittyReads.

I apologise. Realised that it is antibodies (IGG and IGM) and not GGT. Know the GGT stands for gamma something or other'. Not sure if I've had those other blood tests unless I've not got results of them. I never got the one for Wilson's Disease so wouldn't surprise me. (I had the Wilson's Disease one (for copper overload) before I was diagnosed with PBC. I remember the GP saying it was one of the ones he had taken but never told me of the result. The consultant mentioned that when I saw him that it came back negative.

I know there was considerably more bloods on my 2010 print outs and never really took much notice as I never got print outs until I was diagnosed and had reason to query a Vitamin D one that I was informed was 'a bit low, not too bad'.

The GGT one apparently can show if the liver is inflamed.

[Sammie7]

Hi hgreen

When I was first diagnosed my IGG and IGM were both out of range(no figures given to me)I only recently found out (diagnosed August 2014 with PBC ) that my my IGG is within limit now, albeit at the top end of normal but my IGM is still very high. IGM is more related to PBC but from reading posts on this site IGG is often high as well. One doctor at Kings was very surprised that my IGM was still high after taking urso and my lft's were very nearly all within limit. Despite doing my own research I am not sure if my IGM should be lower. At one point I drove myself mad analysing every out of range blood test, most to do with inflammation. I feel fine so far despite being diagnosed with sjorgens (no symtoms) as well. To answer your question I think it is quite a normal finding. Wis

[GrittyReads]

I suggest that you get in touch with the 'PBC Foundation': there is a link to their website at the top of the page, just click and you can find details for contacting their trained advisors, either by phone or email. They are a charity, first set up when the founder discovered there was little info out here for people with PBC. They are relaxed, friendly and well trained.

I remember that people in the past have talked of IGG and IGM in relation to their PBC diagnosis. At that time I had not heard of those two chemicals, and did not find much useful online. Now, there does seem to be more info on IGG and IGM, online, but if you want to know more about it linked specifically to the risk of PBC, then I really think talking to the 'PBC F' people would be better. If you want wider input on the relevance of these blood tests to any liver condition, they may be able to point you in the right direction, or you can contact the 'British Liver Trust', who also have a website on this 'Health Unlocked' site. Go to 'HU' and search their 'community' lists.

PBC is usually diagnosed by the presence of (1): [raised] anti-mitochondrial antibodies (AMAs) (usually subtype M2) in the blood; and (2) high liver function tests such as the ALP and ALT that you mention; or by (3) biopsy.

Symptoms help the medics as a guide in what conditions should be tested for, but symptoms alone are not enough for a diagnosis, of PBC, as other liver conditions - and other autoimmune conditions - can cause similar symptoms.

Most people are diagnosed with PBC by having (1) and (2), above, but a biopsy may be given if all is not clear. Few people have mentioned IGG and IGM, and while they may be a useful guide in relation to PBC, I 'think' they are relevant to other conditions too. I really think it would help to talk to the PBC F, or the BLT.

Hope this helps, and good luck.