Antimitochondrial antibodies (AMA) are primarily associated with Primary Biliary Cholangitis (PBC), but they can also be present in other conditions. Here are some causes of positive AMA results outside of PBC

1. Drug-Induced Liver Injury: Certain medications, such as isoniazid, methyldopa, and chlorpromazine, may induce AMA production.

2. Autoimmune Hepatitis (AIH): While not as common, some patients with autoimmune hepatitis may also test positive for AMA alongside other autoantibodies such as antinuclear antibodies (ANA) or smooth muscle antibodies (SMA).

3. Cholestatic Liver Diseases: Conditions like primary sclerosing cholangitis (PSC) can sometimes show AMA positivity, although it is more characteristic of PBC.

4. Systemic Lupus Erythematosus (SLE): Some SLE patients may have positive AMA, particularly in cases with hepatic involvement.

5. Rheumatoid Arthritis (RA): Although not a classic association, certain RA patients may exhibit AMA.

6. Non-Alcoholic Fatty Liver Disease (NAFLD): There have been reports of non-alcoholic steatohepatitis (NASH) cases with positive AMA.

7. HCV Infection: Chronic hepatitis C virus infection may be associated with the presence of AMA in some patients.

8. Other Autoimmune Conditions: Various autoimmune disorders such as Sjögren’s syndrome can display AMA positivity.

9. Infectious Hepatitis: Some viral hepatitis infections, especially those showing significant liver damage, may have AMA in the serum.

10. Metabolic Syndrome: Certain metabolic diseases can manifest with AMA positivity in conjunction with liver involvement.

Post-Polypectomy Recommendations (AGA, Gupta et al. 2020)

palliative care for cirrhosis

1. A strategy to support patients
2. Interventions proven to relieve symptoms
3. Tools proven to guide decisions
4. Complements the goals of transplant

palliative care is not a referral. It is a strategy. A way of caring

Cardiofundal gastric varices bleed🩸less commonly than esophageal varices or GOV1 gastric varices

BUT the management can be challenging!

New AGA clinical practice update on sclerosing mesenteritis—a rare, often silent condition affecting the bowel mesentery.

“test-and-treat” strategy is recommended to ensure eradication of the H.Pylori bacteria in ;

Ø All patients with active PUD;

Ø Patients with dyspepsia under the age of 60;

Ø Patients initiating long-term, non-steroidal, anti-inflammatory drugs;

Ø Patients with unexplained iron deficiency anemia

Ø Adults with idiopathic thrombocytopenic purpura