Guest guest Posted March 22, 2004 Report Share Posted March 22, 2004 Doc is not happy with my results. My ast/alt levels were somewhere around 300-400. They came down less than 10 points. Now he is saying that the antismooth muscle antibody that tested positive still tests positive but when they retested it, it didn't come out as high? I had no idea what he was talking about. I was supposed to have labs done again on Thursday, but he had me go today and he will call me tomorrow with what the next step is. He said he had expected my results to be more normal. I take 20 mg of prednisone - which is a relatively small dose compared to what others take. WAY confused tonight - but hopefully tomorrow I will know more. Cora Quote Link to comment Share on other sites More sharing options...
Guest guest Posted March 27, 2004 Report Share Posted March 27, 2004 Cora, sorry to hear your liver enzymes were not down as much as the doctor had hoped. How long have you been taking the prednisone? I was diagnosed with AIH in Jan 03 and was lucky to get to start the prednisone at only 20 mg. Luckily my liver enzymes were near normal after only 2 1/2 weeks on 20 mg of prednisone and that was after them being near 800. However, I don't think it's at all unusual for it to take longer for the liver to respond to the medication than it did in my case. Are you also taking Imuran? I wasn't put on Imuran until July or August 03. I'm currently on 100 mg of Imuran daily and 2.5 mg of prednisone daily. I also have chronic pancreatitis, which causes my liver enzymes to elevate when I have an acute attack. Other than that, my liver enzymes are typically in the normal or near normal range. Take care and let us know how things are going. Quote Link to comment Share on other sites More sharing options...
Guest guest Posted March 27, 2004 Report Share Posted March 27, 2004 When I first started seeing the doctor they were in the 300-400 range and then they started coming down. When I started prednisone (at 20 mg) they were around 150 I guess. They came down 10 points. I've been on the meds since mid Feb., which I don't think is that long. Last lab they came down another 10 points. I am taking Imuran 100 mg (50 in the morning and 50 at night.) I really didn't expect the levels to drop so quickly - so I guess I was surprised when the doc said he had hoped they would be normal. I just don't understand what he is talking about now with the anti-smooth muscle antibody. He said that isn't as high as one normally sees with someone with AIH - but I kinda got the impression that if you test positive for the anti-smooth muscle antibody it means you have something autoimmune going on somewhere - maybe I'm wrong. Cora > Cora, > sorry to hear your liver enzymes were not down as much as the doctor had hoped. How long have you been taking the prednisone? I was diagnosed with AIH in Jan 03 and was lucky to get to start the prednisone at only 20 mg. Luckily my liver enzymes were near normal after only 2 1/2 weeks on 20 mg of prednisone and that was after them being near 800. However, I don't think it's at all unusual for it to take longer for the liver to respond to the medication than it did in my case. Are you also taking Imuran? I wasn't put on Imuran until July or August 03. I'm currently on 100 mg of Imuran daily and 2.5 mg of prednisone daily. I also have chronic pancreatitis, which causes my liver enzymes to elevate when I have an acute attack. Other than that, my liver enzymes are typically in the normal or near normal range. > > Take care and let us know how things are going. > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted March 27, 2004 Report Share Posted March 27, 2004 Cora, I'm not really even sure of the relevance of testing for the anti-smooth muscle antibody once you have already tested positive for it. I have only been tested for it once and it was negative. However, my ANA or anti-nuclear antibody was positive the very first time it was ever tested back in 1995. For the most part, it has been positive almost every time since then except about 2-3 times when my lupus seemed to be less active. My rheumatologist told me when it was negative that it just meant that the plaquenil that I take for the lupus was working well. I've also been told that for the most part, the ANA is not really a good indicator of level of disease activity, so once you have a definitive diagnosis, there's not a lot of reason to re-test it very often. I do know that you can have a positive ANA and not have any autoimmune diseases. However, if you have a positive ANA and symptoms, you need to be looked at more closely and further testing for autoimmune diseases needs to be done. I don't know as much about the anti-smooth muscle antibody since I tested negative for it the one time I was tested for it. Hopefully, your liver enzymes will start coming down a little more quickly soon. From what my doctors told me, it's very individual from patient to patient how quickly the liver responds to medication when one has AIH. Take care, Quote Link to comment Share on other sites More sharing options...
Guest guest Posted March 28, 2004 Report Share Posted March 28, 2004 >Hopefully, your liver enzymes will start coming down a little more quickly soon. From what my doctors told me, it's very individual from patient to patient how quickly the liver responds to medication when one has AIH. > > Take care, > My hep was shocked that mine came down so fast after two weeks of only Imuran. He said he had never seen a patient's levels come down so quickly. I was taken off the prednisone because the levels were not responding at all. These diseases and their responses to treatment are very individual. Sandy C. Quote Link to comment Share on other sites More sharing options...
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