I have had elevated levels of AMA twice. First i got tested in October, now in July

[james828]

What does it mean? My ALT and ALP levels seem normal.

The M2 test was positive (30 units in Oct last year ) and now 36 (in july this year). On holidays and have googled non stop. Could this be fatty liver of is it PBC?

[GrittyReads]

Hi James,

Testing +ve for AMAs, even for AMA-M2 (which is the main sub-type of AMA that codes for PBC) is not enough for a diagnosis of PBC. Your Medic should have told you this, and he/she should be following the exact guidelines/protocol for the formal/official diagnosis of PBC. This means that to be formally diagnosed with PBC you have to have 2 out of 3 of the 3 recognised diagnostic criteria for PBC: that is:

1 - the presence of AMAs = antimitochondrial antibodies eg: (AMA-M2). And/Or:

2 - Blood / liver function tests (lfts) - over a period of time - that clearly show abnormal levels of the chemicals most associated with PBC (eg: ALP, ALT, AST - and my Prof checks on GGT). And/Or:

3 - A Liver biopsy that shows damage to the minute biliary tubules of the liver, which is typical of PBC (fibroscans are often now used instead/as well in some countries)

[NB 1 and 2 are usually enough for a diagnosis]

Some people (about 5% of PBC sufferers) don't have AMAs; this is when a biopsy may be offered, although symptoms will help decide, as well.

If you have AMAs and strong symptoms of PBC (and it's in your family, or if your family or you are prone to autoimmune conditions - they often appear in groups), but your lfts remain perfect, they may test you over a longer period, or do a biopsy.

NB You don't mention if you have symptoms.

I have had AMAs since 1992 (possibly all my life) and I don't have PBC - or any symptoms, and I am in good health. Just having AMAs is not enough for a diagnosis of PBC, and UK Blood Donor statistics show that about 10% of the population have AMAs, but only about 1.5 - 2.0% of those go on to develop PBC. You will need to be tested every year, from now on, eg: I have lft/gen blood tests every year, and still don't have PBC.

Do check out the 'PBC Foundation' website, it is a mine of info and you can talk to their trained advisors by phone or email. Hope this helps, take care.

Gritty

[james828 in reply to GrittyReads]

Thank you so much. I have slightly elevated ALP levels. Also i have been experiencing strange tingling and twitching all over my body since last october. Not sure if they are related. My next follow up with the doctors is in id August.

[badpiglet in reply to james828]

Hi James,

You might also want to get your doctor to check all your vitamin and mineral levels in August, if they haven't been checked already.

But above all, stop googling! You could worry yourself silly unnecessarily. As Gritty has said, AMA's on their own, with no symptoms, do not mean you have a firm diagnosis of any disease/condition. Stress and worry will not help you, so maybe do your best to resist the temptation to google - remembering that many websites and articles now are inaccurate or out of date or both.