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PBC and PSC

PBC: Diagnosis

abnormal liver function tests

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alkaline phosphatase usually 3-4 times elevated

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normal or minimally elevated transaminases (<3x)

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elevated serum cholesterol and IgM often seen

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jaundice, hypoalbuminemia, and coagulopathy seen in later stages of the disease

serologic testing

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AMA present in 90-95% (the best have sens=98%, spec=96%)

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RF found in 70%

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ASMA in 66%

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anti-thyroid in 40%

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ANA in 35%

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