anti-smooth muscle AB in lupus (or other CTD)?

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Date Joined Jan 2004
Total Posts : 4151
   Posted 12/28/2010 11:41 AM (GMT -6)   
hey everyone, long time blush .. I hope you all had a wonderful holiday :-)
I have a bit of an issue that I'm kind of worried about but trying not to stress too much over.  This past year I had some complaints of nausea that I raised to my rheumy so of course she wanted to do a full liver panel and some deeper tests (this was back around June).  I didn't realize but she was testing my anti-smooth muscle antibody, at the time it did come back weakly positive.  Slight concern, but she said we would monitor it in a few months.
I had also had been spilling bilirubin into my urine for the past two years but all liver panel blood tests (enzymes and bilirubin, etc) always come back normal - only abnormal was a few years ago GGT was elevated but seemed to be a fluke since that has been low ever since.  Every urine test shows bilirubin though but none in my blood.
Well I go back again in October for a follow up to my ASMA test and now its positive/positive.  She sends me to one of the best hepatologists and he examines me.  He looks at all my blood work (yes, I tend to bring everything LOL) and examines me and says he doesn't think its anything to do with my liver since its not enlarged and my enzymes are ok - all the while I'm cringing this guy is going to send me in for a liver biopsy STAT!  He says that its not uncommon for this antibody to show up in connective tissue diseases.
Now I have been digging and can't find much on this theory of his.  ASMA (antismooth muscle antibody) is usually an indicator of autoimmune hep.  Now he is a top notch hepatologist but I'm almost inclined to get a second opinion.  And also the fact that my rheumy didn't offer the theory that it could be related to my lupus.
Ok, sorry for the novel.  I guess my question is does anyone have the ASMA antibody and not have autoimmune hep and is this antibody just a possible marker for a lupus or other CTD?
ETA: I asked him about the bilirubin in the urine (which shows up in every urine test for the past two years) and he says not to be too concerned about that... ok ... I just don't know shakehead
I know I can't crosspost and I was torn whether to post this in here or the hep section but I know some in here have autoimmune hep so I thought this was a better place since there may be some here also with this antibody and no hep.

Dx: IBS, Diverticulosis, Idiopathic Acute Colitis, SLE, Sjogren's, Localized Scleroderma, Raynauds
Meds: Plaquenil 400mg/day, Pred 5 mg/day, Topamax 100mg/day, Lodine 500mg/day, Protonix 40mg/day Methotrexate 10mg/week, Arava 20/mg (what next???), Vicoprofen PRN, Flexeril PRN, Fiorinal PRN, Baby aspirin, Prenatal Multi, Vit E, B12, Fish Oil, Biotin, Calcium, Folic Acid

New Member

Date Joined Jun 2011
Total Posts : 8
   Posted 6/5/2011 11:37 AM (GMT -6)   
Hi Dbab

I was just wondering did you ever get anywhere with your smooth muscle antibodies test?
I recently had that myself, 1:320 positive, though I had ANA and anti DNA positive as well, and was diagnosed with Systemic Lupus. I also had high liver enzymes (ALT and GGT both over 400). The doc said it was due to my gall stones flare and had it removed and said not to worry about liver.

I am still thinking that positive anti-smooth muscle can be something else than Lupus or Gallblader for example autoimmune hep.
Did anybody answer about positive ASMA without having autoimmune hep? Or did you find out anything else since?

Hope you keeping well (all things considered) turn
Dx: Glomerulonephritis, Low Kidney function, GERD, Nutcracker esophagus, Systemic Lupus (dx 2011), Anemia (low ferritin, low RBC)
Surgical: Two kidney surgeries with partial nephrectomy, cholecystectomy, multiple puppiloma/fibroma -ectomies
Meds: Plaquenil 400mg/day (starting soon, waiting for eyes check), Nexium, Galfer 600mg/day, Solpadol 120mg/day-180mg/day
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