1:40 positive diagnosis criteria

[Dwaffle16]

All of the information out there says that For PBC an AMA level of 1:40 is positive. One thing I do not understand is The lab test I had (AMA (M2 EP) says that 25 and over is positive. Can someone explain this to me as I do not understand. Thanks.

[gwillistexas]

I think you’re confusing AMA with ANA. ANA Titer is 1:40=normal

[gwillistexas]

ANA Titer should be less than 1:40 to be normal

[Angel_b]

Hi I think it depends on the lab that’s doing the testing. They all seem to have slightly different variations on results. It could be that >1:25 at the lab yours went to would be equal to 1:40 in another, depending on their methods.

[gwillistexas in reply to Angel_b]

My labs were done at a Pathology Lab in Austin. Their AMA normal is <.20. If you research ANA, I think you’ll find <1:40 is normal. Can’t believe different labs would vary in that respect regardless of who performs the test.

[Angel_b in reply to gwillistexas]

Hi geillistexas.

You could be right. I’m all long way of from being an expert lol. I’m in uk so ranges might be different over here. It said on the pbc foundation app that it was 1:40 but to be honest I wouldn’t worry about any difference between the labs. The doctor needs to put together all the information to give a diagnosis so probably only matters whether it’s positive or negative.

[Dwaffle16 in reply to gwillistexas]

You are right. The lab I am referring to considers less than 20 normal. They call between 20 and 25 equivocal.

[mjk98]

ANA negative but ANA <90

[GrittyReads]

If you are worried about a PBC diagnosis, then you need more diagnostic checks/criteria to be satisfied, than high AMA levels on their own. Plus some people just 'have' high AMAs, without it ever causing PBC.

[Dwaffle16 in reply to GrittyReads]

Yes I also have elevated ALP levels for almost two years. I am waiting for an appointment with a specialist to further investigate this possibility.

[GrittyReads in reply to Dwaffle16]

Where do you live? The diagnostic tests/procedure for diagnosing PBC - in the UK - have recently been discussed, debated, and formalised and agreed at a high level (leading PBC specialists and researchers) and published. If you contact the 'PBC Foundation' who host this site (link at top of page, with phone and email contacts) you can access links to a copy of this document, as well as the PBC's own 8-page summary of this official/formal guide (it's for all liver/PBC/Gastros).

NB You may have to join the 'PBC F' to get this degree of access, but it's free, and their website and advisors are brilliant.

You might want to get a copy, read it, and take it along to your appointment. High ALP is one of the signs of PBC (as well as the presence of AMA-M2) but a good PBC specialist, or hepatologist (liver specialist) would take a long view, check lots of other liver function tests, and blood tests ... and probably check your general health and family health history, too. I know that people in the States and elsewhere seem to be sent to general Gastro, which I don't understand, as PBC is pretty rare (despite all of us on here!), and many won't have come across it. Ditto general doctors/GPs. In my UK practice, only 1 out of 4 of the GPs have ever had patients with it.

Hope this helps.

[Dwaffle16 in reply to GrittyReads]

Thank you for all of that wonderful information. I live in upstate New York. My appointment is January 22. If this doctor thinks PBC is a good possibility I will certainly join the PBC foundation for better information. I am seeing a gastroenterologist that does specialize in liver problems and treats PBC. After making the appointment I kind of wish I had gone to A hepatologist instead but I will see what he says. I do have many many chronic symptoms such as debilitating nausea.

[GrittyReads in reply to Dwaffle16]

Glad you found it helpful.. I would still read around on the 'PBC Foundation' website, as it is all up-to-the minute info. A lot of stuff online about PBC is out-of-date and overly scary. Also you might feel more secure if you are more 'on top of' the whole PBC diagnosis scene, before you go back to your Gastro.

Nb If you post on here again, I would say that you are in the US, as lots of the lovely, helpful, caring folk who post and reply on here are from the States (I know it's a long shot, but some may even be in your area!) and they will be able to give advice that's better suited to the US health system.

Mind you, several of them have said how good the 'PBC F' website and advisors etc, are ... compared to the PBC Orgs in the US.

Take care, above all, don't stress! Do things you love, treat yourself, have fun. Stress is the worst for any autoimmune issues ... plus PBC is not the issue it used to be, the treatment available now works brilliantly for most, and advances are constantly being made.