Primary Biliary Cholangitis
Publication Date: August 24, 2021
Last Updated: March 14, 2022
Guidance Statements
Diagnosis
1. The diagnosis of PBC can be established when two of the following three criteria are met:
3. Liver biopsy to rule out concomitant AIH or other liver disease should be considered in PBC patients when the alanine aminotransferase activity is more than 5 times the upper limit of normal.
4. In cases of suspected PBC/AIH overlap, treatment should be targeted at the predominant histological pattern of injury.
- Biochemical evidence of cholestasis based on ALP elevation.
- Presence of AMA, or other PBC-specific autoantibodies, including sp100 or gp210, if AMA is negative.
- Histologic evidence of nonsuppurative destructive cholangitis and destruction of interlobular bile ducts
3. Liver biopsy to rule out concomitant AIH or other liver disease should be considered in PBC patients when the alanine aminotransferase activity is more than 5 times the upper limit of normal.
4. In cases of suspected PBC/AIH overlap, treatment should be targeted at the predominant histological pattern of injury.
Follow-Up of PBC
Having trouble viewing table?
Liver tests every 3-6 months |
---|
TSH annually |
Bone mineral densitometry every 2 years |
Vitamins A, D, E and prothrombin time annually if bilirubin >2.0 |
Upper endoscopy every 1-3 years if cirrhotic, Mayo risk score >4.1, or transient elastography shows a score ≥17 kPa* |
Ultrasound with or without alpha fetoprotein in patients with known or suspected cirrhosis† and men every 6 months |
Overview
Title
Primary Biliary Cholangitis
Authoring Organization
American Association for the Study of Liver Diseases