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[Krichards1971]

So my liver ultrasound and the other ultrasound they done was normal. But liver enzymes and AMA are elevated. Does anyone else have normal ultrasound but abnormal labs?

[GrittyReads]

Hi Krichards1971,

The ultrasound is good for ruling out all sorts of other issues, including gall bladder and main bile duct problems. Plus, it can also detect large scale, or mass, scarring in the liver, so it's really good that all that is clear, as mass scarring would be for advanced cirrhosis. However, an ultrasound is no good for seeing any minute scarring of the tiny ... microscopic ... biliary tubules, which are the first bits to get damaged if it is PBC. Formally, officially, ultrasound is not considered good enough for a diagnosis of PBC.

To diagnose PBC, 2 out of 3 diagnostic criteria have to be met, they are:

1 - abnormal liver function tests (lfts) typical of PBC - most often raised ALP, GGT, ALT - and/or:

2 - the presence of raised AMAs (antimitochondrial antibodies) typical of PBC (most often the sub-type of AMA, M2 - and/or:

3 - a liver biopsy that shows damage to the tiny biliary tubules, that is typical of PBC.

Most people are diagnosed with 1 and 2, and a biopsy is generally used just to confirm PBC if lfts are abnormal but there are no AMAs (some people have PBC without AMAs). However, if you have symptoms of PBC eg: itching, fatigue, muscle aches, that is another sign ... 'however' symptoms alone are not enough for a diagnosis: officially, according to international health guidelines ... it has to be 2 out of the 3 listed above.

If you just had AMAs they would keep monitoring your liver enzymes, in case PBC develops, but some people just have AMAs and nothing ever develops (I've known of my AMAs since 1992, but still no signs or symptoms of PBC, and lfts checked every year and still normal).

It does depend which liver enzymes are raised in your case, and they may monitor you for a while, but it may be PBC. However, that is not something to dread. Don't read stuff online, as most of it is out-of-date and overly scary. Great steps have been made in recent years and the medication is so good that once diagnosed people can often get back to normal.

I would talk to the trained advisors at the 'PBC Foundation' - link at the top of the page to their website, where you will find email and phone contact details. Also their website is a mine of up-to-the minute info on PBC, with loads of details, including a copy of the recent rulings on diagnosis. Many GPs still don't know much of this, as PBC is still fairly rare. I would read all their site, and read around on here, although their info is all correct - sometimes on here it can still be just opinion.

Above all, if it is PBC, stay calm, don't stress. If it is PBC it doesn't have to be awful. Also, the worst things for these sorts of autoimmune conditions is stress: so .. have fun, do things you love, that make you happy ... just maybe ... not alcohol, and also try to have a good healthy diet with exercise, but not too much, don't go mad!

Read around on the site, and talk to the 'PBC F' advisors, and join - it's free - for even more info, and try to become your own best expert and friend ... although there's always support on here.

Hope this helps, take care.

[Krichards1971 in reply to GrittyReads]

Thank you. My LFT's and AMA are high. A few other labs are abnormal also.

[Sachin1234 in reply to GrittyReads]

Well said..love it !! I still drink beer and wine tho I'm working on it quit 🙏🙏

[Sachin1234]

Pbc is slow progressing disease as you know it can take a long time to effect in our liver tho we might have abnormal labs.. how is ursodiol working for you?

🙏🤗

[Krichards1971 in reply to Sachin1234]

It going good. Helps the memory some but i still have good and bad days.

[Sachin1234 in reply to Krichards1971]

We all have a good and bad days ! My worst time during days is evening where I get so tired for an hour! The other problem I have to face everyday is body getting hot any random time! Me and my endocrinologist thinking it must be due to my reactive hypoglycemia from pbc 😭

[Michiganpbc]

Yes all ultrasounds normal for me stage 2 PBC.

[Sachin1234 in reply to Michiganpbc]

🙏