Hi,
Thanks for posting your query on DoctorSpring.com
Can you explain in detail what you wanted to know?
It would help me answer your query far better if I knew what you mean by the words 'long term' , 'overdose', and your specific medical history.
Patient replied :
Well in 2001 i had no problems and had a negative AMA test. I was then given a double overdose of rifinah for seven and a half weeks 1200mg rifampicin per day and 600mg isoniazid per day. After this i was very weak and ill and i was left with hepatits that lasted 6 months and a positive AMA test since diagnosed as PBC. I have also had POTs syndrome and some other ilnesses come on shortly after. I have found numerous reports sugesting a link between these events and i am looking for some further information. Thank you.
Hello,
Thanks for providing the additional information.
AMA can be positive against many different antigens (For eg M1 M2 etc).
Isoniazid can cause liver injury and can also result in development of antimicrobial antibodies (AMA) against M6 antigen.
AMA against M2 is more specific for primary biliary cirrhosis.
You can get a liver biopsy done if not done already for further evaluation.
Let me know if I can assist you further.
Patient replied :
So is it possible that the Isoniazid may have triggered pbc or that the drug induced hepatitis may have triggered it? AMA negative before overdose and positive after overdose.
Hi,
Are you AMA positive against M2 antigen or M6 antigen?
Regards.
Patient replied :
It is the m2 antigen. The research i have done involving apoptosis, caspase 3 and oxidative stress seem to suggest a link is there. When you consider that a healthy man in his early 30s has developed pbc (a liver condition that mainly women get) just after an overdose of a liver damaging drug which induced chronic hepatitis. it seems that there would be a link there.
thanks
Hi,
I would say it is a rare possibility or even unlikely for medications like INH to induce antibody against M2 antigen.
More research work is needed to look for this link.
I would advise you to get a liver biopsy done ( if not done already) to confirm the diagnosis of PBC.
Regards.