Primary Biliary Cholangitis

Your healthcare provider will ask about your medical history and symptoms and physically examine you. Then they’ll test a sample of your blood for evidence of PBC. They look for particular antibodies in your blood that are associated with PBC, especially one called antimitochondrial antibody (AMA). They also look for elevated liver enzymes that indicate liver stress, especially alkaline phosphatase.

If your test results are positive for PBC, your provider will want to look at images of your liver and biliary system next. This helps to rule out other possible causes of your symptoms, and can also help show how advanced the disease is. They’ll usually begin with a simple test like an abdominal ultrasound. But sometimes, they may need to take clearer images with some type of MRI (magnetic resonance imaging).

About 5% of people with PBC test negative for AMA but have other signs and symptoms. In this case, your provider may need to take a liver biopsy to confirm you have PBC. They can usually do this as a bedside procedure using a needle inserted into your liver. The needle will withdraw a tiny tissue sample, and your provider will send the sample to a lab for examination under a microscope.