I'm New Here, Needing Help Reading A Biopsy

Hello all, I'm 61 yrs old and I've had AIH for 30 yrs. I was doing well until 2 months ago I had slightly elevated AST 66 and ALT 77 also ALP 130. I had an Ultrasound an MRI (I was told I have Cirrhosis) an Endoscopy (which found no varices) and finally a Biopsy. I can't get in to see my Dr. for 18 more days. I was hoping one of you could give me some help reading this report, BTW I had no idea I might had PBC:

FINAL DIAGNOSIS:

LIVER, BIOPSY:

1. LIVER DEMONSTRATING FEATURES MOST CONSISTENT WITH AN OVERLAP

SYNDROME OF AUTOIMMUNE HEPATITIS AND PRIMARY BILIARY CIRRHOSIS.

2. FIBROSIS STAGE 3, ACTIVITY GRADE 2. SEE COMMENT.

COMMENT: The morphologic features include occasional granulomata,

biliary proliferation and onion skinning, which are more consistent

with primary biliary cirrhosis. Occasional plasma cells are also

identified, and an autoimmune component is most likely present as well.

Recommend clinical correlation as well as AMA and viral serologies.

Thanks for any help

4 Replies

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  • I would contact the 'PBC Foundation' and talk to one of their expert advisors. They host this site on 'Health Unlocked' and there is a link to their website at the top of the page, where you will find email and phone links. They are really helpful and supportive, and you will find lots of other info on their website.

    Also, if it is PBC, try not to worry, as the situation is so much better now for sufferers, as new drugs are appearing as I write! Also, the use of the main drug, Urso, which has been around for a while, has already made things so much better for people with PBC.

    Thanks for posting that detail though, I had no idea what sort of a comment they made on biopsy reports, so interesting to read, but I don't know that there will be many of us who will be in a position to give you advice with it. Not many people in the UK are given biopsies, as PBC is usually identified with blood tests.

    Take care, and do spoil and treat yourself, meanwhile! Also, try to avoid stress and take care. This is a lovely supportive community and you will get a lot of help and information on here.

  • Thank you for the encouragement and the info about the Foundation. There is some good reading there for sure. This autoimmune stuff is a real pain in the *** I think the Drs. make some of these words up as they go when they're writing these reports (just kidding). I guess my Dr. will have me get an AMA test after seeing this. I did test positive in an ANA test but didn't have an AMA. After reading on the Foundation it seems the AMA is Critical to the diagnosis.

  • Usually PBC is diagnosed by the presence of AMA - M2 [ ... NB there are different sorts, or 'sub-types' of AMA, and M2 is the one that is usually linked to PBC, other types of AMA are more linked to other autoimmune conditions ...] as well as abnormal levels of the liver chemicals (in 'liver function tests') that are typical of PBC (other liver conditions can affect the levels of different chemicals).

    Most people get a diagnosis because they have AMA-M2 and abnormal liver bloods. However, a small % of people can have PBC yet do not have abnormal liver tests, these are the people who are usually given a biopsy.

    Is the ANA already being dealt with? I'm afraid I don't know that much about it.

    Hope it all gets sorted and you are not left worrying for too long. Take care and come back on here whenever you have anything to ask, as everyone is very supportive.

    Nb Just to say: people do not seem to check in here so much at the weekends and holiday times: both asking and answering questions. So if you want to post more questions, you will get many more replies if you do it on weekdays.

  • I think the ANA test was done by the Dr. because he didn't know me and wanted to see for sure that I had autoimmune disease. I was referred to him by my Endocrinologist because all of a sudden my enzymes were elevated and he said I should see a Gastroenterologist. I also have Type 1 Diabetes on top of the AIH. Thanks again for the info about the AMA, hopefully I'll be having that test done. After the MRI he said I had Cirrhosis but he never mentioned PBC so he might be surprised to see this.

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