Your doctor will first ask you about your health history and your family's health history, and perform a physical exam.
The following tests and procedures may be used to diagnose primary biliary cirrhosis.
- Blood tests to check liver function. Liver function tests check the levels of enzymes that may indicate liver disease in general and bile duct injury in particular.
- Blood tests to check for signs of autoimmune disease. An analysis of your blood may reveal anti-mitochondrial antibodies (AMAs). These antibodies almost never occur in people who don't have the disease, even if they have other liver disorders. Therefore, a positive AMA test is considered a very reliable indicator of the disease. However, a small percentage of people with primary biliary cirrhosis don't have AMAs.
- Ultrasound. Ultrasound uses high-frequency sound waves to produce images of structures inside your body.
- Computerized tomography (CT scan). You may have a CT scan — a special X-ray technique that provides much more information than a standard X-ray does.
- Magnetic resonance imaging (MRI). An MRI scanner uses a magnetic field and radio waves to create detailed images of organs and tissues. Unlike CT, there is no radiation exposure with MRI.
- Magnetic resonance elastography (MRE). This newer test combines MRI imaging with sound waves to create a visual map (elastogram) of internal organs. The test is used to detect hardening of your liver that might indicate cirrhosis, similar to the way a doctor would examine (palpate) your body.
- X-rays of your bile ducts. You may need a type of bile duct X-ray called endoscopic retrograde cholangiopancreatography (ERCP) in addition to or instead of an MRI. To make your bile ducts visible on an X-ray, your doctor uses a flexible tube passed down your throat to inject dye into the area of your small intestine where your bile ducts empty. This test is invasive and may result in complications. With advances in MRI, it is usually not needed for diagnosis.
If the diagnosis is still uncertain, doctors may perform a liver biopsy. A small sample of liver tissue is removed and examined in a laboratory, either to confirm the diagnosis or to determine the extent (stage) of the disease. Doctors withdraw the tissue through a small incision using a thin needle.
May 16, 2017
- Ferri FF. Ferri's Clinical Advisor 2014: 5 Books in 1. Philadelphia, Pa.: Mosby Elsevier; 2014. https://www.clinicalkey.com. Accessed Oct.8, 2014.
- Picco MF (expert opinion). Mayo Clinic, Jacksonville, Fla. Oct. 25, 2014.
- Primary biliary cirrhosis. The National Digestive Diseases Information Clearinghouse. http://digestive.niddk.nih.gov/ddiseases/pubs/primarybiliarycirrhosis/index.aspx. Accessed Oct. 8, 2014.
- Juran BD, et al. Environmental factors in primary biliary cirrhosis. Seminars in Liver Disease. 2014;34:265.
- Lindor, KD, et al. Primary biliary cirrhosis. American Association for the Study of Liver Diseases Practice Guidelines. Hepatology. 2009;50:291.
- Poupon R. Clinical manifestations, diagnosis, and natural history of primary biliary cirrhosis. http://www.uptodate.com/home. Accessed Oct. 8, 2014.
- Boyer TD, et al., eds. Zakim & Boyer's Hepatology: A Textbook of Liver Disease. 6th ed. https://www.clinicalkey.com. Accessed Oct. 8, 2014.
- Poupon R. Overview of the treatment of primary biliary cirrhosis. http://www.uptodate.com/home. Accessed Oct. 8, 2014.
- Flamm S, et al. Liver transplantation in primary biliary cirrhosis. http://www.uptodate.com/home. Accessed Oct. 8, 2014.
- Honda A, et al. Anticholestatic effects of bezafibrate in patients with primary biliary cirrhosis treated with ursodeoxycholic acid. Hepatology. 2013;57:1931.
- AskMayoExpert. What is magnetic resonance elastography (MRE) and what are the indications for an MRE examination? Rochester, Minn.: Mayo Foundation for Medical Education and Research; 2014.
- Singal AK, et al. Model for end-stage liver disease. Journal of Clinical and Experimental Hepatology. 2013;3:50.
- PCBers. http://pbcers.org/. Accessed Oct. 8, 2014.
- Mells GF, et al. Impact of primary biliary cirrhosis on perceived quality of life: The UK-PBC national study. Hepatology. 2013;58:273.
- American Liver Foundation. http://www.liverfoundation.org/support/. Accessed Oct. 21, 2014.
- Venkatesh SK, et al. Magnetic resonance elastography of liver: Clinical applications. Journal of Computer Assisted Tomography. 2013;37:887.
- Imam MH, et al. Pathogenesis and management of pruritus in cholestatic liver disease. Journal of Gastroenterology and Hepatology. 2012;27:1150.
- Bunchorntavakul C, et al. Pruritis in chronic liver disease. Clinics in Liver Disease. 2012;16:331.
- Golden AK. Decision Support System. Mayo Clinic, Rochester, Minn. Oct. 6, 2014.
- Martin P, et al. Evaluation for liver transplantation in adults: 2013 Practice guideline by the American Association for the Study of Liver Diseases and the American Society of Transplantation. Hepatology. 2014;59:1144.