AMA titer of 1:20, everything else normal. Please advise.

[Lemur279]

Hello, so I've spent the last 3 weeks in a state of constant anxiety because I had a blood test which showed that I am positive for AMA's with a titer of 1:20. The reason for the test was elevated liver enzymes found in a routine blood test, but that was evidently due to alcohol (I drank a bottle of wine the night before) - my liver was retested a few weeks later, at the same time I had the AMA test, and all my enzymes have returned to normal since abstaining.

So, to the point: I am very confused, because it seems that my AMA level is barely above normal range (which is apparently under 1:20 according to the lab results). I've also read things, though, which say that a normal titer is under 1:10...so I'm basically wondering if anyone has any thoughts with regard to whether I may have PBC. I have not heard anything from the specialist whom my GP sought advice from following the positive AMA result, and I don't know when I will - my country is now in lockdown so everything is delayed. For context I'm a 26 year old man and I am healthy other than the apparent presence of AMAs in my bloodstream. All IGM, ALP, ALP GGT etc levels are totally normal. Slightly low white blood cell count is the only other abnormality (3.8, while minimum normal level is 4, yet my lab result notes nevertheless say "no abnormality detected" in that regard).

I'm also confused about whether everyone has AMAs or not. Does my 1:20 titer simply mean that I am positive, period (which is scary) or does it mean that I am extremely close to a normal level of AMAs (which would presumably be 1:19 and below)?

Thanks in advance.

[Mpbc]

Not to worry, Lemur279. It looks like your AMA is close to normal - but even if not - you need two criteria - high AMA but also elevated ALP to be diagnosed with PBC - and your ALP is close to normal. (<1:20)

I just went through a similar worry - and finally got to see a hepatologist who told me I only have a predisposition to BPC but I don’t have it and I don’t need any treatment. He said I should have liver enzymes checked every 6 months in case anything changes - but if it does - URSO treatments are well tolerated and usually effective. My AMA Titer is much higher than yours at 1:640 and I also have high ANA Titer. My ALT and AST were slightly elevated at 45 and 50 and my GGT was high at 143. Everything else is normal.

Again - in order to have a diagnosis of BPC - you need two things - positive AMA and elevated ALP and your ALP is close to normal.

I’ve read that 10% of people (mostly women) have elevated AMA normally and only 1.5% to 2% of them go on to get BPC. I’ve also read that if you have AMA - it’s likely you always will - that doesn’t change.

Hope this helps and hope the specialist will ease your concerns as well. Good luck to you!

[Lauralee851]

Hi there, I got an AMA positive and also ANA about 8 years and I’m still not diagnosed as having PBC. Ive seen that my specialist writes that I have ‘an autoimmune liver condition’ but he doesn’t specificy and I’m ok with that now. My liver stats have been up and down over the years and I see my specialist every 3 months to a year depending on what my test results are like each time. I’m 36 and healthy 🙂 xx