PBC Foundation

Worried and stressed out

I just delivered in August, but during the pregnancy I was diagnosed with pregnancy cholestasis. My liver enzyme Alk Phos. was elevated towards the end of the pregnancy, but the doctor didn't seem concerned. In October the doctor repeated the labs and the Alk Phos was four points from being normal. In November I was experiencing joint pain and my family physician redid the labs and now my Alk Phos., AST, ALT and GGT are slightly elevated and the ANA was negative.

I had a ultrasound that stated slightly echogenicity throughout the liver parenchyma with no lesions and stated it could be from hepatocelluar disease such as steatosis. My doctor referred me to a GI doctor and he ordered labs to check AMA, ANA, Hep panel, ASMA and another liver function. The labs were drawn on Wednesday and hopefully they'll be back on Monday.

Any advice? I have been worried since Wednesday.

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Try to keep calm, though easier said than done. You will probably hear by Monday. Whatever is the outcome, your GI will guide & help you through the next steps. Most likely you may be referred to a Hepatologist if the GI feels it is warranted. Once you have a diagnosis, you can start on treatment & will be fine. It is good that your family doctor has taken the next steps to advance your care. Just think about which doctor you would like to manage your overall care since he/she can work with you to give you confidence & answer your questions. This doctor should be someone you have a rapport with & listens to you. This will make you feel so much calmer moving forward. Write down a list of your questions & concerns, most important ones first so that your doctor can address them.

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Thank you for responding.

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Don't worry; you will be fine because looks like whatever it is, was caught early. Distract yourself with something fun. Focus on the upcoming holidays & your baby.

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If you have fatty liver then this is the best news possible because your liver can return to normalcy with proper steps taken.

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Wait and see what your blood results are first there is no point in worrying until you get all results

Good luck

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Alk phos is not specific to liver but is present in growing bones, that is why they are not concerned during pregnancy. It is very common to have high alk phos during pregnancy and for a number of months after.

It could be that the hormones of pregnancy have exacerbated your liver issues and that after a few months things will settle down. Its good they are giving you further tests to rule out other problems.

I wish you well, try not to worry too much, the DR's are doing the right things. Congratulations, enjoy your little one.

E x

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Thank you

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Congratulations on your newest family member!

Pregnancy can do a myriad of things to your system and sometimes latent conditions can be triggered. Sometimes when that happens, they rescind and go dormant as your body recalibrates. If they don't, know that there are treatments available.

Keep in mind that the most important member in any treatment team is you! Be involved, be informed, and be positive. And when you start to stress, look at it, let go of what's not in your control, and go hug that little miracle💞

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Thank you

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The nurse called and said all the labs were normal, but when I looked online at my chart my ANA was elevated to 1:80. Any advice?

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My ANA was 1:640. normal is <1:40 st the lab mine was tested

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That's was the range for my test too.

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I live in Texas. My Internist sends all special testing to Clinical Pathology Lab in Austin. That’s where my ANA & AMA we’re tested. You’ll be okay😊

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Did it give the labs reference range. These are different depending on what the lab uses. I think as its so recent that you've had your baby, they may suggest waiting and redoing the test. Antibodies may be affected be pregnancy, things can take a while to settle.

If however they do suspect auto immune illness ( such as auto immune hepatitis), they may want to confirm it with more detailed scans and / or biopsy.

If caught early it is a treatable condition and with medication can be totally controlled.

Again try not to worry, avoid google, there is a lot of misinformation out there, which is old/ inaccurate and often scary.

There is a British liver trust on health unlocked, and they have a really good website, with current accurate info.

Hope the Dr's can give you answers, but be prepared for more tests and more waiting until anything is confirmed or ruled out.

Take care,

E x

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Thank you

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You’re welcome

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<1.40 negative

1.40-1.80 low antibody level

>1.80 elevated antibody level

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Good to know we’re in the middle. Tks!

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