{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,6]],"date-time":"2026-07-06T14:15:49Z","timestamp":1783347349283,"version":"3.54.6"},"reference-count":21,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"6","license":[{"start":{"date-parts":[[2015,9,1]],"date-time":"2015-09-01T00:00:00Z","timestamp":1441065600000},"content-version":"tdm","delay-in-days":10531,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[1986,11]]},"abstract":"<jats:sec>\n            <jats:title\/>\n            <jats:p>Twenty-nine patients with a positive antimitochondrial antibody titer \u22651\/40, who were detected during screening for other autoimmune disease, are described who had a normal serum bilirubin, alkaline phosphatase and transaminase and who had no symptoms of liver disease at presentation. Liver biopsies in 12 of the 29 fulfilled diagnostic criteria for primary biliary cirrhosis; a further 12 were consistent with primary biliary cirrhosis, but only 2 were normal. There was a high incidence of other autoantibodies and autoimmune diseases, especially thyroid antibodies and disorders. Sixteen of these patients have been followed for over 4 years since diagnosis (mean = 6 years, range = 4 to 9 years) and for a mean of 8.7 years since initial detection of the antimitochondrial antibody (range = 4 to 13). Five of 16 developed symptoms suggestive of primary biliary cirrhosis, and 11 of 16 developed elevation of alkaline phosphatase. The antimitochondrial antibody activity in these patients was in the same IgG subclasses (predominantly IgG<jats:sub>1<\/jats:sub> and IgG<jats:sub>3<\/jats:sub>) as that seen in a group of 23 patients with clinically, biochemically and histologically advanced primary biliary cirrhosis. All showed the same abnormalities on quantitative estimation of the total IgG subclasses in serum; relative excess of IgG<jats:sub>3<\/jats:sub> and, to a lesser extent, IgG<jats:sub>2<\/jats:sub> was exhibited. It is concluded that, in this study, the finding of an antimitochondrial antibody titer \u22651\/40 is strongly suggestive of primary biliary cirrhosis even in the absence of symptoms and the presence of a normal alkaline phosphatase.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1002\/hep.1840060609","type":"journal-article","created":{"date-parts":[[2007,3,3]],"date-time":"2007-03-03T20:24:50Z","timestamp":1172953490000},"page":"1279-1284","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":193,"title":["Positive antimitochondrial antibody but normal alkaline phosphatase: Is this primary biliary cirrhosis?"],"prefix":"10.1097","volume":"6","author":[{"given":"Harriet C.","family":"Mitchison","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Margaret F.","family":"Bassendine","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alex","family":"Hendrick","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mark K.","family":"Bennett","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Graham","family":"Bird","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alexander J.","family":"Watson","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Oliver F. W.","family":"James","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","reference":[{"key":"10.1002\/hep.1840060609-BIB1","doi-asserted-by":"crossref","first-page":"136","DOI":"10.1136\/gut.22.2.136","volume":"22","author":"Mu\u00f1oz","year":"1981","journal-title":"Gut"},{"key":"10.1002\/hep.1840060609-BIB2","doi-asserted-by":"crossref","first-page":"444","DOI":"10.1136\/gut.14.6.444","volume":"14","author":"Fox","year":"1973","journal-title":"Gut"},{"key":"10.1002\/hep.1840060609-BIB3","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1056\/NEJM198301063080101","volume":"308","author":"Roll","year":"1983","journal-title":"N Engl J Med"},{"key":"10.1002\/hep.1840060609-BIB4","doi-asserted-by":"crossref","first-page":"267","DOI":"10.1016\/0016-5085(85)90325-7","volume":"69","author":"Beswick","year":"1985","journal-title":"Gastroenterology"},{"key":"10.1002\/hep.1840060609-BIB5","author":"Lehmann","year":"1985","unstructured":", . Is primary biliary cirrhosis a different disease in the elderly? Gerontology 1985; 186\u2013194."},{"key":"10.1002\/hep.1840060609-BIB6","first-page":"1278","volume":"1","author":"James","year":"1981","journal-title":"Lancet"},{"key":"10.1002\/hep.1840060609-BIB7","author":"Tunbridge","year":"1977","unstructured":", , et al. The spectrum of thyroid disease in a community; the Whickham Survey. Clin Endocrinol 1977; 481\u2013493."},{"key":"10.1002\/hep.1840060609-BIB8","first-page":"237","volume":"1","author":"Doniach","year":"1966","journal-title":"Clin Exp Immunol"},{"key":"10.1002\/hep.1840060609-BIB9","doi-asserted-by":"crossref","first-page":"235","DOI":"10.1016\/0019-2791(65)90004-2","volume":"2","author":"Marcini","year":"1965","journal-title":"Immunochemistry"},{"key":"10.1002\/hep.1840060609-BIB10","first-page":"387","volume":"46","author":"Rubin","year":"1965","journal-title":"Am J Pathol"},{"key":"10.1002\/hep.1840060609-BIB11","first-page":"1257","volume":"60","author":"Scheuer","year":"1967","journal-title":"Proc R Soc Med"},{"key":"10.1002\/hep.1840060609-BIB12","volume-title":"Frontiers in liver disease","author":"MacSween","year":"1981","unstructured":", . The morphology and immunology of primary biliary cirrhosis. In: , eds. Frontiers in liver disease. New York: Thieme-Stratton, 1981."},{"key":"10.1002\/hep.1840060609-BIB13","doi-asserted-by":"crossref","first-page":"814","DOI":"10.1136\/gut.23.10.814","volume":"23","author":"Triger","year":"1982","journal-title":"Gut"},{"key":"10.1002\/hep.1840060609-BIB14","doi-asserted-by":"crossref","first-page":"1015","DOI":"10.1136\/bmj.286.6370.1015-a","volume":"286","author":"Riggione","year":"1983","journal-title":"Br Med J"},{"key":"10.1002\/hep.1840060609-BIB15","doi-asserted-by":"crossref","first-page":"123","DOI":"10.1016\/S0168-8278(86)80015-0","volume":"2","author":"Berg","year":"1986","journal-title":"J Hepatol"},{"key":"10.1002\/hep.1840060609-BIB16","doi-asserted-by":"crossref","first-page":"1437","DOI":"10.1016\/S0016-5085(19)30497-4","volume":"78","author":"Williams","year":"1980","journal-title":"Gastroenterology"},{"key":"10.1002\/hep.1840060609-BIB17","doi-asserted-by":"crossref","first-page":"258","DOI":"10.1136\/bmj.3.5717.258","volume":"3","author":"Murray-Lyon","year":"1970","journal-title":"Br Med J"},{"key":"10.1002\/hep.1840060609-BIB18","first-page":"529","volume":"7","author":"Schaffner","year":"1982","journal-title":"Progr Liver Dis"},{"key":"10.1002\/hep.1840060609-BIB19","doi-asserted-by":"crossref","first-page":"557","DOI":"10.1136\/bmj.2.6086.557","volume":"2","author":"Child","year":"1977","journal-title":"Br Med J"},{"key":"10.1002\/hep.1840060609-BIB20","doi-asserted-by":"crossref","first-page":"18","DOI":"10.1177\/003693308002500104","volume":"25","author":"Mills","year":"1980","journal-title":"Scot Med J"},{"key":"10.1002\/hep.1840060609-BIB21","doi-asserted-by":"crossref","first-page":"97","DOI":"10.1080\/00325481.1979.11715175","volume":"65","author":"Schaffner","year":"1979","journal-title":"Postgrad Med"}],"container-title":["Hepatology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1002%2Fhep.1840060609","content-type":"unspecified","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.lww.com\/01515467-198611000-00008","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,12,1]],"date-time":"2024-12-01T11:06:25Z","timestamp":1733051185000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.lww.com\/01515467-198611000-00008"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[1986,11]]},"references-count":21,"journal-issue":{"issue":"6","published-print":{"date-parts":[[1986]]}},"URL":"https:\/\/doi.org\/10.1002\/hep.1840060609","relation":{},"ISSN":["0270-9139"],"issn-type":[{"value":"0270-9139","type":"print"}],"subject":[],"published":{"date-parts":[[1986,11]]}}}