Anti-Mitochondrial Antibody (AMA) - IFA (Qualitiative)

Mitochondria are energy centres of your cells. They're the engines that keep most of your body's cells running. Anti-mitochondrial antibodies (AMAs) are blood proteins produced when your body attempts to attack its cells, organs, and tissues. When this occurs, the body's immune system fights it as if it were infected.  

Apollo 24|7’s AMA test aids in the effective detection of abnormally high quantities of such antibodies in the bloodstream. The anti-mitochondrial antibody test is most commonly used to diagnose Primary Biliary Cholangitis (PBC), formerly known as Primary Biliary Cirrhosis, an autoimmune illness. It indicates that your body is rebelling against itself, mistaking healthy cells for sickness or alien matter.  

PBC is an inflammatory disease affecting the liver's bile ducts, causing inflammation and scarring. It is a gradually progressing condition that leads the liver to degenerate and bile flow to obstruct.  Such obstructed bile ducts can cause a build-up of toxic compounds in the liver, which can cause lifelong scarring. Females between the ages of 35 and 60 are the most likely to get PBC. 

Autoantibodies are antibodies that form in response to antigens in the body. M9 and M2 are most likely to induce sickness amongst the 9 variants of AMA antigens (M1–M9). The M2 form of AMA has explicitly been detected in PBC, but the other varieties have been found in various disorders. 

The following are some of the signs and symptoms of PBC:  

• Weariness 
• Jaundice or skin yellowing  
• Fluid accumulation in the abdomen  
• Loss of weight 
• Itchy skin  
• Discomfort in the upper right abdomen area
• Parched lips and eyes  
• Swelling of the feet and hands or Edema

An anti-mitochondrial antibody test is thus performed to help validate a physician's clinical diagnosis of PBC. Usually, when an AMA test does not discover any AMAs, it is deemed normal. However, a negative anti-mitochondrial antibody test does not always eliminate the condition. AMAs aren't found in the blood of 5 to 10% of persons with PBC.  

But if you test positive for AMAs, the findings will also reveal your AMA-M2 (titer) level. But you may receive positive AMA test results even if you have one of the following autoimmune diseases: ‌ 

• Scleroderma 
• Thyroiditis 
• Lupus 
• Rheumatoid arthritis 

So, before affirming a diagnosis of PBC, physicians may suggest liver imaging tests or a liver biopsy. Given that the presence of unsatisfactory AMA test results is insufficient to diagnose the condition, your doctor may require additional tests, such as: 

• IgM level 
• C-reactive protein (CRP) 
• Alkaline phosphatase (ALP) 
• Antinuclear antibodies (ANA) 
• Albumin 
• Bilirubin 
• Prothrombin time (PT)  
• Smooth muscle antibodies (SMI) 
• GGT 
  
  Medically reviewed by Dr. Raj Palaniappan, Sr. Consultant, Gastroenterologists from Apollo Hospitals Greams Road, Chennai

Frequently asked questions

What are the risks involved in the AMA test?

When the AMA test sample is collected, you may feel some uneasiness. There may be tenderness at the puncture site during or after the anti-mitochondrial antibody test. The consequences of a blood draw are generally negligible. Obtaining a sample may be challenging, resulting in the use of several needle sticks, severe bleeding at the injection site, or fainting due to blood loss. Furthermore, a hematoma (blood accumulation under the skin) or infection at the injection site are also possible complications.

What is the procedure for administering the AMA test?

A blood sample is required for the anti-mitochondrial antibody test. Your blood will be drawn from a vein surrounding your elbow or hand by a nurse or technician. This sample will be drawn into a tube and submitted to a laboratory for testing. When your results are ready, your physician will contact you to discuss them.

What does it mean to have a high AMA?

PBC is the most probable source of symptoms of liver damage if the AMA or AMA-M2 level in the bloodstream is elevated. But the amount of AMA in a person’s blood has little to do with their PBC symptoms' severity or prognosis.

What is the normal range for the AMA test?

The lack of anti-microsomal antibodies in the bloodstream is a normal outcome of the anti-mitochondrial antibody test. If present, average AMA concentrations in healthy people are typically less than 35 IU/ml of blood.

Is it possible that a positive AMA test result means nothing?

An individual who does not have the ailment is unlikely to have a positive AMA test result. However, some patients with a positive AMA test but no other symptoms of liver illness may develop PBC over time. Abnormal results owing to other types of liver problems and autoimmune illnesses are occasionally discovered.

Is there a way to cure PBC?

Primary Biliary Cholangitis has no specific cure. However, there are medicines that can assist in slowing the disease's course and avoiding complications.