Hepatology International

, Volume 6, Issue 4, pp 790–795 | Cite as

Complete spectrum of AMA-M2 positive liver disease in north India

  • Ranjana W. Minz
  • Navchetan Kaur
  • Shashi Anand
  • Ritu Aggarwal
  • Biman Saikia
  • Ashim Das
  • Yogesh K. Chawla
Original Article



This study describes the clinical, histological, and genetic profile of AMA-M2 positive liver disease in north India.


Over 13.5 years, 11,221 patients suspected of AiLD (autoimmune liver disease) and negative for viral markers were screened for autoantibodies, ANA, ASMA, AMA, and LKM, by indirect immunofluorescence. Of these patients, 135 were AMA positive and 132 AMA-M2 positive. Clinical presentation of most of these patients was neither typical of AIH nor PBC. Sera of these patients were further tested for gp 210 and Sp 100. Fifty consecutive consenting patients were typed for HLA class II alleles DR and DQ and their clinical, biochemical, histology and genetic profiles were reviewed to characterize the disease spectrum in north India.


Only 22 of 50 patients had liver histology reports, and could be categorized on the basis of the criteria by Chazouillers et al. Of these 22, 13 had overlap syndrome, eight had classical PBC, whereas one had probable PBC. The remaining 28 could not be suitably categorized due to lack of liver histology. HLA DRB1*03 was found to be significantly associated with the disease in North Indian population.


This 13.5-year study demonstrates a definite rising annual incidence of AMA-M2-positive liver disease in north India. Complete evaluation of 50 patients indicated that a hepatitic variant of PBC (PBC-AIH), which is significantly associated with DRB1*03, predominates in north India.


Antimitochondrial antibodies Primary biliary cirrhosis Autoimmune hepatitis Overlap syndrome Human leucocyte antigen 



The authors acknowledge Mrs. Ranjit Sharma for her substantial contribution toward autoimmune screening of the patients. This work was supported by a research grant from Indian Council of Medical Research, New Delhi, India.

Conflict of interest

The authors declare no conflict of interest.


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Copyright information

© Asian Pacific Association for the Study of the Liver 2011

Authors and Affiliations

  • Ranjana W. Minz
    • 1
  • Navchetan Kaur
    • 1
  • Shashi Anand
    • 1
  • Ritu Aggarwal
    • 1
  • Biman Saikia
    • 1
  • Ashim Das
    • 2
  • Yogesh K. Chawla
    • 3
  1. 1.Department of ImmunopathologyPost Graduate Institute of Medical Education and Research (PGIMER)ChandigarhIndia
  2. 2.Department of HistopathologyPost Graduate Institute of Medical Education and Research (PGIMER)ChandigarhIndia
  3. 3.Department of HepatologyPost Graduate Institute of Medical Education and Research (PGIMER)ChandigarhIndia

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