I had a strongly positive AMA test in January 2012 and April 2012. I had a live biopsy and was told that I have fatty liver disease.

[alledamarie]

I just had blood work done recently and my AMA is no longer positive. How is this possible?

[kosy2]

I would first suspect that the latest test is in error. Did the biopsy confirm PBC? According to the research I have done there is a high rate of lab errors as well as differences in biopsy dx. I had 2 different hospital's read my biopsy slides and came away with 2 different results.

[Hidden]

HI, I've read that AMA can come and go. Did they confirm PBC?

[alledamarie]

The biopsy showed inflammation and fatty liver disease.

[KarenRL]

Like prades states above, I've also heard of the AMA antibody coming and going over time. AMA is just one piece of the PBC puzzle. Some people, like myself, haven't even tested positive for AMA, but are still diagnosed with PBC through biopsy.

[KarenRL]

However, if your biopsy didn't confirm PBC, then maybe it was a lab error?? As, I think the biopsy is the best way to diagnose PBC. I would get another test in a few months...just for peace of mind.

[alledamarie]

The dr suggested another lab test. My AMA was 41. I start medication tomorrow. This is the fourth test in a little over a year to indicate a positive AMA. Thanks for taking the time to answer my questions.

[Hidden]

Hello alledamarie.

I have read with interest your question on here and this is my view...

...first of all you didn't state how it came about you had a liver biopsy. Did you have any symptons which prompted LFT blood work or was it just a routine LFT which showed it was abnormal?

As I understood it, there is a sort of pathway the NHS use here with regards to the first abnormal LFT. Then each step takes it to something else, ie a repeat LFT as alcohol can affect it but if that isn't the underlying occurrence then another blood test for something else or to rule something out (ie is it bone or liver related?) and so forth. You would normally then have an ultrasound scan which is then followed by more bloods and then a hospital appt.

The final blood test I had after this and that were ruled out and the LFTs still on a continuing elevation was the AMA. Now if this had not have proved positive which in my case it did I would have gone on to have a liver biopsy. With symptons and blood work apparently showing a problem in the liver area then PBC was one projection, hence the AMA but I also had the ANA (negative result).

Apparently the AMA can be variable but a biopsy normally shows up PBC but also other conditions. I personally debate with regards to the actual liver state as a biopsy only takes a sample from the one area it is punctured and that part might show it to be bad when in fact that is only a small proportion of it and as we know we can function with pretty much only a tiny part of a fully working liver. Certain things are widespread as I understand something like cirrhosis is so expect a biopsy can ascertain fatty liver. I know it can be told from the blood work if the liver is suffering from a bit of inflammation (think that is the GGT one without checking).

Reading what you have put it sounds like you could just have fatty liver with inflammation but fatty liver is also something that won't go away as I understand.