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Abnormal Liver Function Tests and Need for Liver Biopsy

Since my earlier note, I have been diagnosed with systemic lupus erythematoses and alpha-1 antitrypsin deficiency (**** variant) this past year.  My amino transferases have been elevated for almost thirty years  (the time of first measurement).  

I had asked my doctors for an A1AT deficiency test for a number of years, but it was only performed a week ago after all other tests other than ANA yielded a negative result on many occasions.

My alpha 1 levels are 34.5% of the upper level of normal rather than the expected 60-70% for my variant.  I have the **** variant and I believe it is likely that either one or both alleles that are defective, leading to my elevated liver transaminases for most of my life.

My gastroenterologist is enthusiastic to perform a liver biopsy, but I believe that it would be unnecessarily invasive given my adverse history with anesthetics and the fact that the A1AT deficiency is the only positive result other than the positive ANA in the liver workup that has been performed over the past 30 years.

I would like to have my hyaluronic acid measured as well as have a Fibroscan or MRE performed to determine whether it is likely that I even have fibrosis before submitting to liver biopsy.  My ratios such as APRI etc. indicate that I shouldn't have cirrhosis or fibrosis.

I would appreciate your viewpoint on suggested next steps and any additional non-invasive testing that should be undertaken before a liver biopsy.

Thank you for your consideration.

bluevalkyrie


This discussion is related to Question for Hepatitis Researcher - Fibroscan Availability.
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Avatar universal

Given you mentioned in an earlier post :

"am seeing multiple physicians without diagnosis to date. Several of these physicians are leaning toward the possibility of lupus, lupoid hepatitis, or autoimmune hepatitis.  To date, testing has ruled out viral hepatitis, '
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This is a discussion forum for those looking for info. and support regarding HCV. I suggest possibly "stating your questions at the "Liver Disorder" forum" or possibly the ""Autoimmune Disorders" forum  would garner helpful responses.
Best...
Will
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Avatar universal
The website appears to have automatically censored my post :)  with **** whenever I list the variant.  The A1AT variant that I have is protease inhibitor SS.  Thank you.
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