AMA test vs AMA M2: I am confused after... - PBC Foundation

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AMA test vs AMA M2

Dwaffle16 profile image
19 Replies

I am confused after reading a lot of information about the AMA test. My result was equivocal 24.3 on an AMA M2 test (positive greater than 24.9) Is this test different than a regular AMA test? If yes, how is it different? My GP specifically said that he is not concerned with this result even though I have had an elevated ALP level (150, 157, 163, and 159) over the last year and a half. Any comments would be appreciated.

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Dwaffle16 profile image
Dwaffle16
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19 Replies

AMA M2 is specifically linked to pbc. What is the range on your labs of alk phos being normal?

As I mentioned in your other post, please find a well respected hepatologist & he/she can help you get to the bottom of this.

Try to find one in a major medical facility like a teaching hospital, they have more experience & know more about rare conditions vs just any doctor.

Meanwhile don't stress. Use the time to make a plan of what you need to do, write down in bullet points what you want to tell the hepatologist, write down all your questions & take that to your appointment.

My hepatologist spent a little over an hour with me the first time I saw him. I was his last appointment of the day & he was extremely gracious explaining everything to me.

Dwaffle16 profile image
Dwaffle16 in reply to

The ALP test reference range is less than 115 at this particular lab.

in reply to Dwaffle16

You definitely should go see a hepatologist. I am surprised that your GP didn't send you already.

Something is going on either with your liver or bones. Elevated alk phos is suggestive of either condition. If your LFT's are abnormal as well, it is most likely the liver & not bones.

I had fluctuating LFT's a bit higher than norm & sometimes normal range over a few years. I was on statins & that could make the LFT's higher.

However after ~2 years of this, my primary care doctor who also happens to be a GI was concerned & wanted a liver biopsy to see what was wrong. He wasn't able to convince me so he sent me to the hepatologist who ran more tests & convinced me to do a biopsy which was used to diagnose pbc.

My primary care doctor was not familiar with pbc, but he knew enough that something was amiss. He told me he had these elevated LFT cases and mostly it was either alcohol induced or fatty liver. PBC is relatively rare in the general population.

Keep us posted!

3phyraX profile image
3phyraX in reply to

My gi doctor told me that ama m2 came out positive because of my fatty liver? So that means fatty liver can turn to pbc? Or alcohol abuse can turn to pbc? Do you have fatty little liver? Or it’s not me necessary fatty liver linked with pbc?

in reply to 3phyraX

Sorry I was not clear, elevated LFT's can be caused by a fatty liver which can be alcohol related.

No, fatty liver does not cause pbc. If the fatty liver is alcohol induced, once the drinking is stopped, it goes away. If it is a non alcoholic induced fatty liver, it is just a condition one has & can be managed not to progress further via diet. My liver sonogram didn't indicate fatty liver which was why the doctors wanted a biopsy.

Dwaffle16 profile image
Dwaffle16 in reply to

Are you allowed to share Dr. names on this website. Or medical facilities? If yes are you able to tell me who your doctor is or what facility you go to. You sound very knowledgeable and seem to have an excellent relationship with your specialist. I often go into Manhattan for medical appointments because that is where my urologist is. I am guessing that is where your doctor is since your name is in New York City girl.

in reply to Dwaffle16

I will private message you.

Dwaffle16 profile image
Dwaffle16 in reply to

Thanks. I did not know you could do that.

in reply to Dwaffle16

Did you get the link?

Dwaffle16 profile image
Dwaffle16 in reply to

Yes thank you. At first I did not know how to retrieve private messages but I figured it out. I will call there tomorrow.

in reply to Dwaffle16

Good!

ETW1 profile image
ETW1 in reply to 3phyraX

Hi, I was diagnosed in October through blood tests and immediately put on Urso. In the summer I had a ultrasound which showed no alcoholic cirrhosis and non fatty liver. I am having a fibroscan in 10 days.

gwillistexas profile image
gwillistexas

There are different AMA codes. M2 is indicative of PBC

Andrei profile image
Andrei

Morning .U should do the AMA M2 test by the method ELISA.There are many ways that the ama can be tested but the ELISA method is the best.

Take care

Here is the Mayo Clinic's explanation of the AMA M2 serum.

I've been diagnosed 29 years and have only ever had this test once - when I was first diagnosed. I'm not sure where you are in the world, but here in Australia, I don't think this particular blood test is repeated, as the actual level is not an indicator of PBC progression (see 'Cautions' in the article).

mayomedicallaboratories.com...

claygi profile image
claygi in reply to

Thank you for the link. I read the “Cautions.” I have CREST Syndrome. I also have a positive AMA screen with a titer of 1:628, there is no signification or it being AMA M2 though, the results have always just shown AMA.

I see a Hepatologist at the UCLA Fleger Liver Institute, here Los Angeles. My doctor is the chief of the program there and he said there is no need to look specifically at whether it is AMA M2 or not. He claims it is irrelevant and that a positive screen is all that is needed along with the other elevated liver numbers. He did not do a biopsy although the GI doc wanted to.

I was diagnosed with PBC in Feb of 2017, started on Ursodiol 900mg, and all my levels came down. I also had a fatty liver for 3 years. I lost 15 lbs and the next ultrasound showed the fatty liver infiltrates were gone.

I wonder after reading that section “Caution”, have I interpreted it correctly? Can CREST Syndrome alone create a positive AMA M2 result ?

in reply to claygi

I'm not too sure about that either, claygi.

I've re-read it a couple of times and the only thing that stands out is, that when it mentions CREST Syndrome it only seems to be talking about just an AMA result, whereas everywhere else in the article it talks about the significance of the AMA M2 Serum and differentiates it from the other antigens.

gwillistexas profile image
gwillistexas in reply to

ANA & anticentromere tests are done in diagnosing CREST. there are many autoimmune diseases in CREST

gwillistexas profile image
gwillistexas in reply to

I looked back at my labs, the ANA & titer includes Centromere B, which mine was high suggesting Schleroderma which falls under CREST. I don’t like to look at my labs. Scary stuff.

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