How do you clinically diagnose primary biliary cholangitis (PBC)?

Per AASLD and EASL guidelines,a establishing a diagnosis of PBC is generally based on the presence of1,2

  • Persistent elevated serum levels of alkaline phosphatase (ALP)
  • Antimitochondrial antibodies (seen in up to 95% of patients)
  • Liver biopsy may be used to establish the histological stage of PBC2

New noninvasive imaging technology may also help to assess fibrosis and cirrhosis in patients with PBC.3

a American Association for the Study of Liver Diseases (AASLD) and European Association for the Study of the Liver (EASL).

References:  1. Lindor KD, Gershwin ME, Poupon R, Kaplan M, Bergasa NV, Heathcote EJ. Primary biliary cirrhosis. Hepatology. 2009;50(1):291-308. doi:10.1002/hep.22906.  2. European Association for the Study of the Liver. EASL clinical practice guidelines: management of cholestatic liver diseases. J Hepatol. 2009;51(2):237-267. doi:10.1016/j.jhep.2009.04.009.  3. Corpechot C, El Naggar A, Poujol-Robert A, et al. Assessment of biliary fibrosis by transient elastography in patients with PBC and PSC. Hepatology. 2006;43(5):1118-1124. doi:10.1002/hep.21151.