Got ANA positive and AMA M2 positive. Am I heading towards PBC

[Sneha_winner]

My immunoglobulin level was 954 my doctor suggested Ana test and I have diagnosed with ANA week positive and AMA M2 positive with value of 18.. Positive for PBC

I have been told I may suffer pbc in future presently my l GGT and alkyne phosphate level is normal..

Undergone ultrasound of liver and stiffness was around 6.3kpa and moderate grade fatty liver moderate fatty liver 287IQR/Median.

Am wondering whether I am progressing towards disease or I can reverse the situation.. Before this I was undergoing ivf treatment same was failed thrice.. Life has not started yet... I want to live healthy and happy life....

Am I really progressing TOWARDS PBC disease.. My brother in law who nephroligist consoled me by saying it is not always necessary to have PBC if ama m2 is positive however vice versa is true that the person having PBC will surely have ama m2 positive..

I was little relaxed but now today am feeling mild pain in my lower abdomen is it related to that... Am i really progressing towards the disease... How to reverse.. Seek all your blessings and prayers..

[CCordier]

Many people here wont understand all the medicalese in your post so it might help to spell it out more clearly.

That being said I think it would be very unusual to have positive Anti Mitochondrial Antibodies (i.e., AMA) but normal liver enzymes. And, a postive ANA (Antinuclear Antiboies) only indicates there are auto antibodes present in your body. It doesnt tell anything about what part of your body is being attacked by your own immune system.

I also had a fatty liver when I was diagnosed with PBC, but I also had elevated liver enzymes, a positive AMA, an enlarged liver, and a positive Fibroscan. Have you had a Fibroscan? If not then I'd strongly recommend it. It will tell you if there is scarring in your liver, which can be caused by PBC (as well as other things, such as alcoholism).

I would relax and not worry about PBC for now if I were you. When I was diagnosed I was told I probably had the disease for at least 10 years without any symptoms. And thankfully I've responded well to Urso and all my tests are normal now.

Regards

Carol C.

[Sneha_winner in reply to CCordier]

Thank you brother your words are healing

[Lorelle09 in reply to CCordier]

I have had a positive AMA and M2 since 2014. I monitor my liver enzymes every three months. Only now May 2023 my AST, ALT and ALP are mildly elevated. My fibro score is normal. I do ultrasounds yearly and that was normal in March and every time before. My gastro has told me for years that he didn’t think I would ever develop PBC since the the only thing was abnormal was my AMAs. I have another blood test to check my liver enzymes in two weeks to see if they are going up or down. If they are remaining at current levels or going up then we have to suspect that I have finally gotten PBC.

Also I have Lupus and Raynauds since 2014.

[Lu11]

Hi, I’m AMA M2 positive with normal liver enzymes. My sonogram showed very mild fatty liver. There are several people here in the same situation. Doctors won’t treat unless ALP is elevated. My Bilirubin is always on the high end of the range, but still they don’t consider me to have PBC. But I have some symptoms that my Mom, who died from PBC had. I also have other autoimmune issues. I think the main thing is to exercise, eat healthy and keep stress at a minimum. 💓

[Lorelle09 in reply to Lu11]

my situation sounds just like yours. Positive AMA for years always normal liver enzymes until this year. I will know in three weeks whether I have developed PBC.

[Lu11 in reply to Lorelle09]

what tests are you doing to determine PBC? Keep me posted please!💓

[Lorelle09 in reply to Lu11]

doctor wants to retest liver enzymes in couple weeks to see if ALP is going up or down. If it is going up not sure what the next step is. I’m assuming ultrasound, mrcp, fibroscan or biopsy.

I have had positive AMA and anti mitochondrial M2 I believe it was 110 since 2014. I take liver blood tests every three months and ultrasound once a year. Has always been good until most recent blood test. I took fibroscan in November 2021 and it was good stage 0 no fibrosis. Did MRCP in June 2021 liver was normal. My last ultrasound in March was normal. I’m hoping for the best. My doctor has told me every year he feels I will never get PBC even though I have the antibodies. I’m not so sure of that right now. I hope my enzymes go down but I’m not sure why they suddenly went so high after having a completely normal test on 4/10, also March and January of this year all normal. I’m perplexed but I’ll find out more and definitely let you know what the next steps are.

[Lu11 in reply to Lorelle09]

Menopause triggered a series of symptoms for me and that’s when I requested an ANA/AMA M2 test as my Mom passed away from PBC. I know that autoimmune conditions are usually triggered by stress, lack of exercise, poor diet. I’ve made a lot of changes in my life in order to get better and my liver enzymes are great! I do have sero negative RA and dry mouth/eyes. I think going by symptoms is a good idea…if you don’t feel well, something’s going on! Keep us posted please 💓

[Sneha_winner]

Yeah.. Very much correct am working on that and praying God to help in making continuous and consistent effort towards the good health

[OdinsMom]

If you don't have elevated LFTs you truly don't have a PBC diagnosis without having a biopsy done. Usually there is something that kicks PBC into gear. It has been theorized for a long time that it can be one major stress factor, ie, death in family, divorce, major surgery, etc that will kick it into gear. Keep up on testing and early treatment then your live shouldn't change much. Like most things early diagnosis and treatment is key.

[Zelda5]

Hi, I'm in the same boat as you. I have a high Ana 1:640. My Ama m2 is 29, although 8-9 yrs ago it was 68. Because the Ana was high they tested me for Sjogrens, Lupus and a few others. They were negative. I do have chronic dry eyes and dry mouth at times. Anyway my Alt was always high just in the 50's range and the rest of my other enzymes were normal. Until recently last year my Alp started going up and it return normal a couple of times, but consistently elevated. It's not very high about 27 points over. My HEPA still believes it could be the fatty liver causing the elevations. He wanted me to lose weight and retest in a few months. I had a biopsy years ago that was negative for pbc and only showed a mild fatty liver. Since PBC in early stages can be heard to catch on a biopsy. I may ask for another one to be done. That is probably the only way to know for sure if it's is more of a fatty liver issue or pbc related. I'd like to know if my fatty liver has advanced. My liver was also enlarged years ago when this all started and its not anymore. The HEPA did give me the choice if I wanted to take Urso or lose weight first. I filled the script but havent started taking it yet, nor have I lost weight. I watched Dr Robert Gish on a forum on Facebook and he said that a biopsy should be done when there's a question if it's fatty liver or pbc. He said they should do two passes with a 16 gauge needle, "I think". So do you have a diagnosis or is it a wait and see kind of thing. Sorry for this being so long.

[Lorelle09 in reply to Zelda5]

my case similar. ANA 640 sometimes 1280. M2 110. Always normal liver enzymes until now. I hope they go back down but I find out in three weeks which way they are trending.

[Sneha_winner]

Thank you for replying on my post... As of now I have been told to take fibroscan to test the stiffness of liver and grade of fat.. My LFT is normal but all my value are higher towards the normal.. So far My doctor has not suggested me for biopsy as all other function are normal. He has advise me to repeat the LFT every three month.. I will be going for the same in this week.. Will share the detail further..