Asymptomatic primary biliary cholangitis in a young patient: an incidental finding

Primary biliary cholangitis (PBC) is an autoimmune disease that is increasingly recognized as an important cause of chronic liver disease. Incidental diagnoses are not uncommon. We report a case of a middle-aged female with persistently elevated ALP activity. During the investigation of cholestasis, anti-mitochondrial antibodies (AMA) were detected in her serum. Ductular reaction with cholestasis was observed in the liver biopsy sample. Based on these findings, a diagnosis of PBC was established and ursodeoxycholic acid therapy was commenced. After several weeks of treatment, biochemical improvement was noted.