Positive antimitochondrial antibody but normal alkaline phosphatase: Is this primary biliary cirrhosis?

@article{Mitchison1986PositiveAA,
  title={Positive antimitochondrial antibody but normal alkaline phosphatase: Is this primary biliary cirrhosis?},
  author={Harriet Mitchison and Margaret F Bassendine and A. M. Hendrick and Mark K. Bennett and Graham Bird and Alexander J. Watson and Oliver F. W. James},
  journal={Hepatology},
  year={1986},
  volume={6}
}
Twenty‐nine patients with a positive antimitochondrial antibody titer ≥1/40, who were detected during screening for other autoimmune disease, are described who had a normal serum bilirubin, alkaline phosphatase and transaminase and who had no symptoms of liver disease at presentation. Liver biopsies in 12 of the 29 fulfilled diagnostic criteria for primary biliary cirrhosis; a further 12 were consistent with primary biliary cirrhosis, but only 2 were normal. There was a high incidence of other… 
Antimitochondrial antibody and primary biliary cirrhosis: can there be one without the other?
TLDR
The term 'autoimmune cholangitis' has been used in three recent series to describe patients with an initial clinical and histological diagnosis of PBC but who were AMA-negative, and there were no significant differences in gender, serum bilirubin or alkaline phosphatase between those with these patients.
Long‐term follow‐up of antimitochondrial antibody–positive autoimmune hepatitis
TLDR
Patients with overt AIH who test positive for AMAs at initial presentation and are treated with corticosteroid therapy have shown no clinical or histologic evidence of PBC despite the continued detection of AMAs over a follow‐up of up to 27 years.
Immunoblotting as a confirmatory test for antimitochondrial antibodies in primary biliary cirrhosis.
TLDR
Data show that immunoblotting with commercially available oxo-acid dehydrogenases is a reproducible method for the detection of antimitochondrial antibodies highly specific for primary biliary cirrhosis.
Primary biliary cholangitis with normal alkaline phosphatase: A neglected clinical entity challenging current guidelines.
TLDR
For the first time, histological diagnosis of PBC is shown in AMA-negative/PBC-specific ANA-positive subjects and the potential role of GGT as a biomarker in PBC patients with normal baseline ALP levels is shown.
Natural history of early primary biliary cirrhosis
TLDR
It is confirmed that before the advent of any clinical or biomedical indications, individuals positive for AMA do have PBC, and patients with AMA but no other signs or symptoms of PBC seem to have slow progression of the disease.
Clinical implications of antimitochondrial antibody seropositivity in autoimmune hepatitis: a multicentre study
TLDR
None of the AMA-positive AIH patients showed signs of evolving PBC features after a median follow-up of up 47 months, and the groups had similar clinical, biochemical and histological features.
Prevalence of coeliac disease in primary biliary cirrhosis and of antimitochondrial antibodies in adult coeliac disease patients in Italy.
  • A. Floreani, C. Betterle, +6 authors C. Sategna Guidetti
  • Medicine
    Digestive and liver disease : official journal of the Italian Society of Gastroenterology and the Italian Association for the Study of the Liver
  • 2002
TLDR
Screening for coeliac disease with antiendomysium antibodies in primary biliary cirrhosis is justified, and screening for antimitochondrial antibodies is advisable in adult coelac disease patients.
Primary biliary cirrhosis. Quantitation of autoantibodies to purified mitochondrial enzymes and correlation with disease progression.
TLDR
The results indicate that this rapid, simple method has a 93% sensitivity and 96% specificity in the diagnosis of primary biliary cirrhosis and the positive correlation with disease progression was not secondary to hypergammaglobulinemia.
Diagnostic and clinical significance of anti-centromere antibodies in primary biliary cirrhosis.
TLDR
The diagnostic and clinical significance of ACA positivity in patients with PBC without SSc has recently been under investigation, with several studies highlighting links to severe bile duct injury and portal hypertension.
Histologically proven AMA positive primary biliary cholangitis but normal serum alkaline phosphatase: Is alkaline phosphatase truly a surrogate marker?
TLDR
In patients who were AMA-positive but had normal ALP levels, more than 80% were associated with histological classic PBC, emphasize the importance of a positive AMA, even with a normal ALP and also question the role of ALP as a sole surrogate marker of cholangitis.
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References

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TLDR
It is concluded that, in the absence of clinical liver disease, the antimitochondrial antibody test alone (as detected by routine immunofluorescent techniques) does not appear to be a specific screening test for primary biliary cirrhosis.
Is mitochondrial antibody diagnostic of primary biliary cirrhosis?
In a series of 218 patients diagnosed as having primary biliary cirrhosis only nine exhibited a negative serum mitochondrial antibody. On examining additional specimens from these patients, seven
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TLDR
The presence of thyroid antibodies showed a highly significant association with lacrimal gland dysfunction but not with liver histologic staging or liver function tests.
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TLDR
The findings suggest that `M' antibodies do not arise merely in response to liver damage and confirm the value of the test for the differential diagnosis between primary biliary cirrhosis and extrahepatic biliary obstruction although care must be taken in interpretation of the results in cases with associated connective tissue disorders where a significant incidence of positive reactions was observed.
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TLDR
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Four asymptomatic patients are described with raised serum alkaline phosphatase values and a positive serum mitochondrial antibody test. In all four needle liver biopsy showed destructive bile duct
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TLDR
A multivariate analysis of clinical features revealed that at the onset of disease, age, hepatomegaly, and elevated levels of serum bilirubin were independent discriminators of a poor prognosis, and a histologic finding of fibrosis limited to portal areas improved this discrimination, correlating with prolonged survival.
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TLDR
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TLDR
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TLDR
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