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Anti-mitochondrial antibodies (AMA) are organ-nonspecific antibodies directed against lipoproteins in the inner membrane of mitochondria.
Anti-mitochondrial antibodies (AMA) are a serological marker for primary biliary cirrhosis (prevalence 90–96%).
Primary biliary cirrhosis is a chronic autoimmune liver disease that causes progressive damage to the small bile ducts.
The developed immune response damages the epithelial cells of the ducts (with antibodies produced against the mitochondrial structures of the epithelial cells).
Clinically, cholestasis (stagnation of bile), hepatitis (inflammation of liver tissue), and fibrotic (connective tissue) degeneration develop – ultimately leading to cirrhosis.
The disease occurs mostly in women and has a genetic predisposition.
Mitochondrial antigens, which are recognized by anti-mitochondrial antibodies (AMA), are divided into 9 subtypes (M1–M9), with M2 being the subtype most associated with primary biliary cirrhosis (99% of patients).
The classes of antimitochondrial antigens are:
Especially important M2, because it is found in almost all cases (≈95–99%) of primary biliary cirrhosis and is an important diagnostic marker.
Patient preparation
The study is conducted both fasting and after meals.
Study material: Venous blood
Method: ELISA
The study identifies antimitochondrial IgG antibodies
Referral norm: Negative
Normally, antibodies to mitochondrial antigens are negative. A positive indicator of the study is most often associated with primary biliary cirrhosis, lupus, rheumatoid arthritis, certain types of cardiomyopathies, etc.
In case of positive research results, it may be necessary to conduct additional studies to confirm the diagnostics.
Other conditions where AMA may be present (less specific)
An ambiguous response from the study requires a repeat test in 2-3 weeks.
A small number of patients with biliary cirrhosis may not have antimitochondrial antibodies (AMA) detected.
Antimitochondrial antibodies (AMA) may sometimes be detected in other liver diseases:
Antimitochondrial antibodies (AMA) can sometimes be detected in other pathologies:
AMA-M2 antibodies
Main use: To confirm the diagnostics of primary biliary cholangitis
The most important and specific marker (~95–99%) is
AMA-M2-3E antibodies
Usage: To confirm the diagnostics of primary biliary cholangitis. More sensitive marker in early stages
Used: when M2 is doubtful or negative, but the clinic is consistent
AMA-M4 antibodies
Usage: Primary biliary cholangitis + autoimmune hepatitis (overlap syndrome)
AMA-M7 antibodies
Usage: Diagnosis of autoimmune inflammatory processes (rarely)
AMA-M9 antibodies
Usage: In the early stages of primary biliary cholangitis
(sometimes precedes the development of M2 antibodies)
Associated with a milder course
Brief summary
Testing process
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