ama positive blood test

[sa03183]

Blood test came back with ama positive, liver biopsy was fine. Why was blood test ama positive?

[Gioielli]

Diagnosing for PBC is found by elevated LFT's particularly Alkaline Phosphatase levels and being AMA positive. The biopsy is carried out to try to gauge the stage you may be in. However, the biopsy is only done in one part of the liver which may or may not be affected. You will probably be put on Urso and have 6 monthly or annual check ups with your consultant. Don't worry the medication should help your symptoms. Have had it for 10 years now and still doing fine. X

[Hidden]

Hello sa03183.

Usually a liver biopsy diagnoses PBC due to cell changes in the liver being apparently consistent throughout.

I know it is said to be also to stage PBC but I disagree due to the liver being a large organ and one part can be damaged and another notso, hence staging just might be questionable.

I was diagnosed with pBC back in December 2010 due to first of all having symptons (itching and fatigue) and then found to have above normal LFTs (liver function test). I finally had an antibodies check and just the AMAs was found to be in a 'high titre' that gave diagnosis. In the UK you can be diagnosed if you are symptomatic and have the 3 criteria with no need for biopsy. A biopsy as I understand is normally taken if a diagnosis is questionable.

[StefTeaches in reply to Hidden]

Do you know what stage you're in since you didn't have the biopsy?

[Hidden in reply to StefTeaches]

Hello StefTeaches.

No. Not actually interested.

At my first hospital appointment following being diagnosed, the consultant reckoned I had probably had PBC 'a few years'. My scan I had a few months prior to seeing the consultant showed my liver and surrounding organs to look normal. The consultant said my bile ducts looked clear as he stated he could see them on the scan picture.

[GrittyReads]

For a discussion on this topic, I suggest you talk to the trained advisors at the 'PBC Foundation' (they host this site on 'Health Unlocked' and there is a link to their website at the top of the page). If you access the site you will find links to either email them or phone. If you are in the UK it's easy, but if you are in the States (or elsewhere you might want to see if there is an advice group closer to home. You can still email the PBC F.

It's not always straightforward to diagnose PBC, there are several alternatives to the 2 most common criteria (checks/tests) used for the diagnosis. Strictly, in the US/UK/Eu, the formal medical guidelines are supposed to be followed, and the guidelines state that 2 out of 3 diagnostic criteria have to be present for an official diagnosis of PBC.

When Medics are trying to diagnose problems with the liver, if they suspect PBC they would usually do:

1) blood tests for the presence of AMAs (antimitochondrial antibodies) as these are present in about 90-95% of people who have PBC. However, about 10% of the population just have AMAs - no one is quite sure why - but the majority don't have, or don't develop, PBC. Also, about 5-10% of those with definite PBC, don't have AMAs.

The 2nd main check for PBC - although this is often noticed first through routine blood tests for various suspected conditions (liver and others) - is that

2) Medics check the various chemicals concerned with normal liver functions = liver function tests = lfts.

Have you had lfts done? And if so were any of the various chemicals outside their usual range? Abnormal readings for the lfts are the other main criterion for the diagnosis of PBC.

If you have abnormalities in the lfts that are typical for PBC, AND you have AMAs, then this is usually enough to diagnose PBC.

As you don't mention other blood tests, it's difficult to say if you may have PBC. A biopsy is only usually given if the Medics are unsure about the diagnosis. As Gioielli says, it may be that the liver is not showing damage yet, or that the section they took was okay.

However, if your lfts are all normal and the biopsy was clear, it's possible you just have AMAs, some people just have them - I do ... I've have had them for 24 years and still no signs of PBC. However, if you have AMAs, and clear lfts you can still develop PBC, so they should test your lfts at least annually, for the rest of your life.

It depends what your lfts were - you don't mention them. Also, do you have symptoms of PBC? It may be you don't have it, so try to not worry, but even if you do, it's not the dread disease that it used to be considered, and if your biopsy was clear that's really good.

AMAs, (there are different subtypes) can also indicate other autoimmune conditions, so your Medics should also be checking for all these other conditions. And, if your lfts are abnormal, they also ought to rule out all other liver conditions, even though you have AMAs.

Sorry it's so long, and so complicated. Come back to me if you have more questions, but do talk to the PBC F people. Above all try not to stress, as this is the worst for any autoimmune condition. Be good to yourself, treat yourself, and have fun - but also try to exercise, avoid alcohol and a fatty diet.

Hope this helps.

Take care.

[Bonnieanne54]

i caught it early, 22 years ago...and my biopsy came back fine. Im so grateful the enzymes creeped up to 150 just this year from 110 for the last 20 years