NAFLD and postive smooth muscle antibody

So ive been miserable for a couple of years now. Started with chronic sinusitis and 3 sinus surgeries. That led into this pain in the middle of my gut and constant headaches, fatigue and weakness. I get extremely hot like hot flashes (im a 29 year old male). So my GI doc did some tests and couldnt find anything. She referred me to university of michigan and they found slightly elevated AST and ALT. Ordered more labs. No hepatitis but a positive smooth muscle antibody. So then i had an ultrasound which showed fatty liver. Thats where they left it. "Lose weight and stop drinking". Im already eating better and exercising more but i cant help but think that theres something more going on. I havent found any info stating that NAFLD can cause a positive smooth muscle antibody. Should i pursue this? Maybe push for a biopsy?

hi Shadowfall47 and welcomr,
glad youre making the necessary changes. losing weight and watching sugar and cholesterol should get you the desired results. Think of this as a lifestyle change. You should have periodic bloodwork to ensure your liver enzymes are normalizing, and your A1C and cholesterol are normal..

I also would take your lab results, to your primary care dr. You should be monitored for your high SMA. I would be very concerned if your liver enzymes remain high after a reasonable time.

NAFLD can not cause a SMA elevation..

liver biopsies are only performed, when liver damage is suspected, or needed for diagnostic purposes.

In the last decade, I have noticed that many people with chronic issues are low in vitamin D. This is also, something to bring up with your PCP.

let us know how your progressing, and best to you

ppm guy said...
hi Shadowfall47 and welcomr,
glad youre making the necessary changes. losing weight and watching sugar and cholesterol should get you the desired results. Think of this as a lifestyle change. You should have periodic bloodwork to ensure your liver enzymes are normalizing, and your A1C and cholesterol are normal..

I also would take your lab results, to your primary care dr. You should be monitored for your high SMA. I would be very concerned if your liver enzymes remain high after a reasonable time.

NAFLD can not cause a SMA elevation..

liver biopsies are only performed, when liver damage is suspected, or needed for diagnostic purposes.

In the last decade, I have noticed that many people with chronic issues are low in vitamin D. This is also, something to bring up with your PCP.

let us know how your progressing, and best to you

So they said that the SMA can be false positive but acknowledged that fatty liver would not cause my abdominal pain and weakness. Im tempted to push to see if i could have a biliary obstruction or adhesions from pyloric stenosis surgery as an infant that are going inseen from CT and ultrasound.

Make sure that they tested you fully for all types of autoimmune hepatitis. If you can get a copy of the labs so you know whats been tested. Make sure that they tested your AMA AntiMitochondrial Antibodies. Lots of people have elevated SMooth muscle Antibodies with autimmune types of hepatitis. Several times doctors tested my SMA instead of my AMA due to confusion. Autoimmune hepatitis and pbc can be very mild and not even need treatment but its good to know. I have really bad fatty liver with the PBC and not much PBC type damage but an ERCP is the gold standard since some autoimmune hep types like pbc only attack the tiny bile ducts. My fatty liver may be due to my inability to properly metabolize fats due to pbc. or due to an autoimmune condition called myasthenia gravis caused by the pbc. my liver enzymes are often unremarkable. They go up and down. Its good you are pursuing more testing. A biopsy may not show damage early on if you have this.

Hi shadowsfall and ppmguy

I wonder if there's any update on shadowsfall's case? I just posted something similar about myself - normal LFT's after weight loss and reduction in alcohol use, but positive for Smooth Muscle Antibodies.

I also noted there is research showing that 25% of people with fatty liver/NASH can show positive for antibodies but in reality do not have auto immune hepatitis upon biopsy. So that does indicate one reason I could be showing SMA's.

Appreciate any comments you have.

Kyle