Primary biliary cholangitis and primary sclerosing cholangitis Quiz: Ace Your Exams
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A 38-year-old woman comes to the clinic for a follow up. At her initial visit a week ago, routine labs were ordered which revealed an elevated alkaline phosphatase level, which was then confirmed with repeat testing. Review of systems is significant for mild pruritus. She has no family history of liver disease. Past medical history is noncontributory. Vitals are within normal limits. Physical examination is unremarkable. Laboratory findings are shown below. Right upper quadrant ultrasound shows a normal appearing gallbladder and biliary tract. Which of the following additional signs or symptoms would most likely be present given this patient’s likely underlying condition?
| Laboratory value | Result |
| Complete Blood Count | |
| Hemoglobin | 13.5 g/dL |
| Leukocyte count | 5500/mm3 |
| Platelet Count | 200,000/mm3 |
| Serum Chemistry | |
| Sodium | 142 mEq/L |
| Potassium | 4.2 mEq/L |
| Chloride | 95 mEq/L |
| Creatinine | 1.2 mg/dL |
| Alanine aminotransferase | 20 U/L |
| Aspartate aminotransferase | 21 U/L |
| Serum albumin | 4 g/dL |
| Serum total bilirubin | 0.8 mg/dL |
| Total protein | 6 g/dL |
| Alkaline phosphatase level | 220 U/L |
| Antimitochondrial antibodies (AMA) | positive |
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