2School of Medicine, Marmara University,, Istanbul, Turkiye
3Department of Gastroenterology, Rize Training and Research Hospital, Recep Tayyip Erdogan University; Rize, Turkiye
4Department of Gastroenterology, School of Medicine, Marmara University, Istanbul, Turkiye; Institute of Gastroenterology, Marmara University, Istanbul, Turkiye; Department of Gastroenterology, School of Medicine, Recep Tayyip Erdogan University, Rize, Turkiye
Background and Aim: This study investigated the risk of the development of primary biliary cholangitis (PBC) in individuals who were incidentally identified as having positive antimitochondrial antibodies (AMA)-M2.
Material and Methods: We retrospectively reviewed extractable nuclear antibody (ENA) panel test results to identify the incidental AMA-M2-positive patients. Patients who filled the diagnostic criteria for PBC were excluded. AMA-M2-positive patients were further evaluated by physical examination, liver biochemistry, liver ultrasonography, and transient elas-tography (TE) and were also closely followed.
Results: We included 48 (n=45, 93% female) individuals with a median age of 49 (range: 20–69) years. The median follow-up duration was 27 months (range: 9–42) after the detection of AMA-M2. Thirty-three (69%) patients had concomitant autoimmune/inflammatory disorders. Twenty-eight (58%) individuals showed seropositivity for ANA, and 21 had (43%) positive AMA. Fifteen (31%) patients developed typical PBC according to the international PBC diagnostic criteria during the follow-up, and five of them (18%) had significant fibrosis (≥8.2 kPA) by TE at the time of PBC diagnosis.
Conclusion: Two-thirds of the incidental AMA-M2-positive patients devel-oped typical features of PBC after a median 27-month follow-up. Our re-sults suggest that AMA-M2 patients should be closely followed up to detect the late development of PBC.