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How is the diagnosis of primary biliary cirrhosis made?
The diagnosis of primary biliary cirrhosis is considered when the doctor suspects that there might be liver inflammation based upon the history
and physical examination. Initially there may be few symptoms like itching or
fatigue to help guide further testing
The diagnosis may be made incidentally should abnormal liver functions be
found on routine blood tests drawn for another reason. Liver function tests
include AST (aspartate aminotransferase), ALT (alanine aminotransferase), GGT
(gamma-glutamyl transpeptidase), alkaline phosphatase and bilirubin. Blood
levels tend to become elevated in liver disease and they may rise in specific
patterns depending upon the underlying cause of inflammation.
Once the diagnosis is suspected, a blood test to check for antimitochondrial
antibody (AMA) is usually done. This is positive in 90% to 95% of patients with PBC.
Other blood tests may be considered including a complete blood count (CBC)
and cholesterol levels.
Imaging of the abdomen by ultrasound,
CT scan or MRI is often considered to look
for structural changes in the liver and to search for tumors.
A liver biopsy, where a thin needle is inserted through the skin to take a
piece of liver tissue, may help confirm the diagnosis. This tissue is examined
under a microscope by a pathologist to look for changes consistent with PBC. It
is also useful in help stage the disease, deciding its severity at the time of