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  • Thoughts on +ANA and mildly elevated ALT

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    Old 05-09-2014, 03:23 PM   #1
    tinac2307's Avatar
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    Thoughts on +ANA and mildly elevated ALT

    Hi to everyone. Your posts and comments on this site are AWESOME and it's great to see such amazing feedback going back and forth. In this day and age, all the knowledge we can get ourselves is huge. That being said, I'm wondering if anyone has any advice on this (long story short):

    I've had Hashimoto's for about 20 years and been on thyroid meds forever. No problems.

    I developed Alopecia Areata about 6 years ago. It sucks.

    Two years ago I started have problems any time I needed dental work on my left side. My nerves would go bezerk in my face. Anyway, this last round led to my dentist sending me to the doctor who sent me to a neurologist who did a gigantic full blood workup. My results came back:

    +ANA (not surprised given my Hashimotos and Alopecia problems)
    Hemogeonous ANA with a titre 1:160 (whatever that means)
    negative for all the lupus, sjogerns (sp?), and sclerdoma tests

    Everything else was normal except an elevated ALT liver enzymes and extremely barely high (1 point above the high end limit) Albumin test. This is the 2nd time I've had an elevated ALT and Albumin. The first was two years ago. They had me go back after a few weeks for a retest and it came back normal.

    This time, they want a retest of the liver (they think it's acetaminophen induced) in a few weeks. But, the ANA just came back and a mention of autoimmune hepatitis was mentioned.

    Anyone have any thoughts on that?

    Thanks for any advice!

    - Tina

    Last edited by tinac2307; 05-09-2014 at 03:25 PM.

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    Old 05-09-2014, 10:18 PM   #2
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    Re: Thoughts on +ANA and mildly elevated ALT

    Well, the ANA can be positive in several different autoimmune disorders, including Hashimoto's, autoimmune hepatitis, lupus, Sjogren's, etc. Your titer is a level of positivity, ie, the higher the second number, the more positive it is. 1:160 is usually considered high enough to be clinically meaningful, but it can go several steps higher (the bottom number keeps doubling). The pattern is not too meaningful and is a description of how it appears on slide. Homogenous looks smooth like milk, where speckled looks clumpy like curdled milk. The ALT can be from liver or skeletal muscle, and how elevated is important. It can be fractionated in lab to separate the liver from muscle component, and I think that should be done. If you take a lot of Tylenol, that could raise it. So could skeletal muscle inflammation, and a CK muscle enzyme should be done to check for that. You sound like you may be having trigeminal neuralgia attacks or perhaps TMJ pain after dental procedures. Both of those can go along with autoimmune disease. Anti-smooth muscle and anti-mitochondrial antibodies can be + in autoimmune hepatitis, so those should be checked, as well as viral sources of hepatitis, just to be thorough. I would avoid all alcohol as well as Tylenol between now and next blood draw for ALT. since they can both be toxic to liver in high amounts. Good luck with this and let us know how this works out for you.

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