diagnosis

Last reviewed 08/2021

PBC should be suspected in patients with chronic cholecystitis after excluding other causes of liver disease (1).

Diagnosis of PBC can generally be established when two of the following three criteria are met:

1. biochemical evidence of cholestasis based mainly on alkaline phosphatase elevation of at least 1.5 times the upper limit of normal for more than 24 weeks
   
   
2. presence of AMA at titres of 1:40 or higher
   
   
3. compatible histologic evidence - nonsuppurative destructive cholangitis and destruction of interlobular bile ducts

Reference:

• (1) European Association for the Study of the Liver. EASL Clinical Practice Guidelines: Management of cholestatic liver diseases. Journal of Hepatology 51 (2009) 237-267           
• (2) Selmi C et al. Primary biliary cirrhosis. Lancet. 2011 May 7;377(9777):1600-9