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Real members of myPBCteam have posted questions and answers that support our community guidelines, and should not be taken as medical advice. Looking for the latest medically reviewed content by doctors and experts? Visit our resource section.

Has anyone had this experience?

A myPBCteam Member asked a question 💭
Greenville, SC

A few months ago I was referred to GI for elevated liver enzymes. Liver panel showed enzymes went up more and I had a positive ANA and AMA. I had a liver biopsy that showed no signs of cirrhosis but showed resolving hepatitis. Blood tests for hepatitis were negative
I did recheck the liver enzymes and they were coming back down a little. They talked about sending me to a rheumatologist for further testing. For now, they just want me to get another liver panel at the end of March. Has anyone… read more

February 2
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A myPBCteam Member

Thank you Lisa! It sounds like quite a journey to get a diagnosis if cirrhosis has not started yet. I hope you stay well!

February 3
myPBCteam

Has anyone else experienced elevated liver enzymes with positive ANA and AMA but unclear diagnosis?

Your situation isn't uncommon when PBC is being investigated. Having positive AMA along with elevated liver enzymes can suggest PBC, but doctors need to rule out other conditions first.

To diagnose PBC, you typically need Show Full Answer

Has anyone else experienced elevated liver enzymes with positive ANA and AMA but unclear diagnosis?

Your situation isn't uncommon when PBC is being investigated. Having positive AMA along with elevated liver enzymes can suggest PBC, but doctors need to rule out other conditions first.

To diagnose PBC, you typically need to meet at least two of these three criteria:

* Elevated alkaline phosphatase (ALP) levels at least 1.5 times the upper limit of normal
* Positive AMA with a titer of 1:40 or higher
* Liver biopsy showing damage consistent with PBC

Since your biopsy showed resolving hepatitis rather than typical PBC changes, and your enzymes are coming back down, your doctors are being appropriately cautious. The monitoring approach makes sense. It's possible to be AMA-positive without having PBC. AMA sometimes appears in people with other autoimmune diseases or can be an early sign before PBC fully develops. About 5% of people with PBC are actually AMA-negative, which shows the diagnosis isn't always straightforward.

If you're AMA-positive but have no symptoms and normal or improving liver enzymes, doctors often recommend ongoing monitoring with blood tests every 6-12 months. This helps catch any changes early.

The referral to a rheumatologist makes sense since positive ANA can indicate other autoimmune conditions. Keep following up as recommended, and don't hesitate to ask your doctors about what specific markers they're watching.

February 2

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