Elevated ana, ama and alt

[Sachin1234]

This is my stat results after my alt went 94 from 50...my ana and ama titter are higher than previous 4 years ago..

My alt went down to 89 and ast normal with a week 🤔

What will be the next line of defense for my liver?

Immunology

ANA Screen

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POSITIVE (Abnormal) ANA Screen

Date: Jan 02, 2019 04:25 p.m. EST

Reference Range:NEGATIVE

ANA Titer

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1:320 titer (High) ANA Titer

Date: Jan 02, 2019 04:25 p.m. EST

ANA Pattern

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SPECKLED (Abnormal) ANA Pattern

Date: Jan 02, 2019 04:25 p.m. EST

Actin (Smooth Muscle) IgG Ab

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< 20 units Actin (Smooth Muscle) IgG Ab

Date: Jan 02, 2019 04:25 p.m. EST

Reference Range:< 20 units

Miscellaneous Testing

Mitochondrial (M2) Ab

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140.5 units (High) Mitochondrial (M2) Ab

Date: Jan 02, 2019 04:25 p.m. EST

Reference Range:<= 20.0 units

[Ktltel]

How have you been feeling?

Stella🙋

[Sachin1234 in reply to Ktltel]

Feeling great Stella..just spiked up immunology and alt recently otherwise I was going fb good ..I just got a called from my dr assistance assuring no cirrhosis cause my plts and pt/inr are well with in normal range..I have next dr visit next month and we will going to discuss about boipsy then

[Ktltel in reply to Sachin1234]

Wonderful! 😊

[VeeWat in reply to Sachin1234]

Is it true that normal platelets and INR mean no cirrhosis?

[Sachin1234 in reply to VeeWat]

It means your liver is functioning well

[Skypony]

Hi, this seems quite complex. Usually the doctor who ordered the tests would discuss the results with you and form a plan. Will you be seeing them soon?

I hope you get the information you need and feel well-supported by your medical team.

Best wishes

[Hidden]

It reads a little complicated except your levels are positive but any judgement and reasons are best done by your doctors. However from your understanding that your AMA and ANA titres are higher than 4 years ago, with regards to the AMA M2 ab, I’ve always understood the level is not indicitave to severity of symptoms or prognosis. I can’t comment on the ANA it’s not one I have looked into. But your nurse specialist would be able to answer your questions.

It does look like the alt was coming back down again though, so that is good news and there are a number of things that can temporarily increase your numbers. Its more about how your numbers are over the longer term. And your feeling good which is always a bonus.

[Sachin1234 in reply to Hidden]

From the beginning I was told I have pbc overlapping aih..I did biopsy and at that time aih was inconclusive..we redo all the test just to make sure that my previous dr might missed the diagnosis of aih.. results shows similar pattern and more pbc then aih cause my actin smooth muscle is negative..

My alt went up 50 to 92 within a month at that period only thing I had change was I stop taking metformin for my reactive hypoglycemia..since I moved from ky to Virginia my stress level has been double fold but I don’t think stress can spike that much in alt..I always drink moderately after diagnosed but my dr that is not s factor. But anyway rt now I’m not touching alcohol anymore.. one thing I notice winter is worst for me..I used to eat semi keto diet with healthy fat but during holidays I stoped started eating what ever means lots of sugar , junk and grissy food..

[Sachin1234 in reply to Hidden]

Candy

It does shows progression even it might have damaged a lot in liver..flare up shouldn’t be constantly high.. more high the titter is more rapidly flaring up so it is better to investigate further that is what I understand from my dr..

[Hidden in reply to Sachin1234]

I will remember that, and ask my doctors I’ve only ever had the one AMA /Ana test at the point of diagnosis. It’s not one that’s been repeated as a test for any flare up or progression.

[Sachin1234 in reply to Hidden]

That’s why my previous dr never repeated those test..this is my new dr he repeated everything and compare with my previous results.. he told me that flare up doesn’t mean necessarily damaging the liver but saying your pbc is highly active something like that..

Previous I was pbc with aih suspicious, this time I’m confirmed pbc/aih😔

I just had 2nd biopsy last Friday waiting for dr call for the results 😔

[Hidden]

It’s good there keeping a close eye on you. I know what you mean about winter months and diet, I seem to want more comfort foods and Christmas had me eating things I wouldn’t normally have. Just trying to reign it in a little and get back on track.

I get symptoms of hypoglycaemia, I control it pretty well with regular, smaller meals. I gave up alcohol about 4 years ago, I was never told to stop but then I only ever had the odd glass of wine with a meal. My downside is the cake/ chocolate, I make determined efforts to keep it down a bit. I cut sugar from tea and coffee I don’t have the alcohol and I don’t drink any sugary/ sweetened drinks, so i keep the cake .

Take care let us know how you get on.

[Sachin1234 in reply to Hidden]

I’m just curious why they haven’t put me on immune suppression when I have an aih symptom too.. my alp has been running 80 to 100 for years now that means pbc is contain I guess..don’t you think I will be better with combo urso and immune suppression med

[Hidden]

They seem like good alp numbers, well below the EASL, 1.67 ULN which is where they like you to be. Mine run at 170/180 for the last few years and a sheer wave elastography came out F0-F1, last year. I was dx nearly 10 years ago so not doing to bad I think.

Not sure about AIH but isn’t it either your ALT or AST that needs to be significantly higher? I mean a lot higher than yours is currently. A good question for you doctors appointment though.

[Sachin1234 in reply to Hidden]

I might be slow burner or the high alt might be the symptoms now..somehow he still wants me to hold off to medicate for aih since my ast is normal with in week and alt is coming down

I’m puzzled 😕

Do u think it would wise to Telly dr to do biopsy