I don't know why they do it, but I really wouldn't worry. The levels of AMA-M2 do not have any significance to how severe, or otherwise, PBC will be.
AMA-M2 is a strong indicator for the presence of PBC, but on it's own it is only an 'indicator'. It is the levels of the various liver function tests that are the most important guide and the main diagnostic clincher (unless you are given a liver biopsy).
I have high AMA-M2 - have had since it was first noted in 1992, possibly all my life - but I don't have PBC. My annual lfts are always normal, I don't have any symptoms of PBC at all and have very good health.
Try not to worry, always the worst thing for any autoimmune condition.
I have not had a liver biopsy, but my general all-round bloods and lfts are taken every year, and always done again if I ever have any odd illnesses. My bloods and lfts have always been perfect and I am in good health, with no symptoms whatsoever of PBC. I was first told of the AMAs in 1992 when I'd gone to my UK Hull GP feeling tired, depressed and achey (but this was after nursing my mother through her final bout of cancer and having to help my father out a lot, while living 100s miles away, being married, in the final stages of a Degree as a mature student, and doing supply teaching).
My then GP had me tested for everything and then sent me to both rheumatologist and hepatologist. Both tested me every which way, and concluded that I was in perfect health apart from being a bit down. I was told I had AMAs and they could be an indicator of certain autoimmune conditions. I had lfts every year, all perfect and with no worries.
Then I moved to Devon (UK) about 10 years ago, and a young, new-to-me GP panicked at the AMAs, & sent me to a different local liver specialist. All was thoroughly checked, as before - but more so - and again I was told I was at risk of an autoimmune condition (although this was the first time I heard of PBC) but that I didn't have it and would probably never get it - just keep on having the annual blood tests. All should have been okay, but when I eventually got a letter from the Liver chap, he had given me a bogus diagnosis that mentioned PBC, but which does not 'formally/officially' exist, and I found this caused all sort of problems with Insurance.
After much complaining and pestering of my GPs, I eventually found the 'PBC Foundation', and was helped by people, on here, who are in the same situation (there are quite a lot of us: about 10% of the population have AMAs, but only about 1.5% ever develop PBC. Some people just have AMAs, like some people just have the blood factor for rheumatoid arthritis, but never get it). Through them I was able to contact one of the UK's leading PBC Consultants, and he suggested I go to see him for another check. This happened nearly 3 years ago, and he conducted all possible tests & examinations ('tho not a liver biopsy) as well as a full survey of my health history and my family medical history. He concluded I do not have PBC, will almost certainly never get it, and if I did, it would be mild. I still have annual bloods/lfts, and they continue to be perfect.
If you checkout the 'PBC Foundation' (link to website and contact details at top of this page), you will find an 8-page summary of a recent official/formal document, produced after lengthy discussion and arbitration by all concerned PBC Consultants and Researchers in the UK. It is an advice document for all UK Health Professionals, and among all the details about PBC it makes it clear that people should not be assumed to have PBC if they only have AMA-M2. It makes the necessary, full diagnostic procedure to be followed, very clear.
Thanks Gritty! I"ll look into that article. Thanks for your thorough reply! I didn't mean to hijack this thread about the labs. Please go back to the regularly scheduled program!
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B and O type Blood and Alkaline Phosphatase and Labs have different ULN
New here! Question about Diagnosis 
Liver Biopsy Negative can it still be PBC?
Not yet diagnosed but feeling awful
