Summary
Definition
History and exam
Other diagnostic factors
- personal hx of autoimmune disease
- FHx of autoimmune disease
- hx of hypercholesterolaemia
- itch
- fatigue
- dry eyes and dry mouth
- sleep disturbance
- postural dizziness/blackouts
- hepatomegaly
- FHx of primary biliary cholangitis
- weight loss and other metabolic features of malabsorption
- memory and concentration problems
- jaundice
- ascites
- splenomegaly
- skin pigmentation
- xanthelasmata
Risk factors
- female sex
- age between 45 and 60 years
- FHx of PBC/autoimmune disease
- smoking
- urinary tract infection
Diagnostic investigations
1st investigations to order
- alkaline phosphatase
- gamma-GT
- bilirubin
- alanine aminotransferase
- serum albumin
- antimitochondrial antibody immunofluorescence
- ANA immunofluorescence
- antipyruvate dehydrogenase complex-E2 ELISA
- anti-M2 ELISA
- antiglycoprotein-210 ELISA
- anti-Sp100 ELISA
- abdominal ultrasound scan
Investigations to consider
- prothrombin time
- serum immunoglobulin
- liver biopsy
- upper GI endoscopy
- serum alpha-fetoprotein
Treatment algorithm
Contributors
Authors VIEW ALL
Professor of Liver Immunology
University of Newcastle
Honorary Consultant Hepatologist
Freeman Hospital
Newcastle-upon-Tyne
UK
Disclosures
DEJJ has received speaker honoraria from Falk, grant funding from Intercept and Pfizer, and has undertaken consultancy work for Falk, GSK, Intercept, and Novartis. DEJJ is an author of a number of articles referenced in this monograph.
Peer reviewers VIEW ALL
Consultant Physician
Liver Unit
Queen Elizabeth Hospital
Birmingham
UK
Disclosures
JN declares that he has no competing interests.
Department of Biochemistry and Molecular Biology
Monash University
Clayton
Victoria
Australia
Disclosures
IRM declares that he has no competing interests.
Professor of Medicine
Chief of Clinical Gastroenterology and Hepatology
University of Texas Medical Branch
Galveston
TX
Disclosures
NS declares that he has no competing interests.
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