Primary Biliary Cirrhosis
How is Primary Biliary Cirrhosis Diagnosed?
Because many people with primary biliary cirrhosis (PBC) do not have symptoms when they’re initially diagnosed, routine blood tests or an evaluation for another condition often brings awareness of the condition to the doctor.
If primary biliary cirrhosis is suspected, the following tests can help in making a diagnosis:
- Liver function tests – Because certain liver enzymes are elevated in most individuals with primary biliary cirrhosis, namely alkaline phosphatase, blood tests are done to check the function of the liver, to check enzyme levels that may indicate liver disease in general and particularly bile duct injury.
- Anti-mitrochondrial antibodies (AMA) – A very reliable test used to determine the presence of primary biliary cirrhosis because most people with primary biliary cirrhosis have anti-mitrochondrial antibodies – antibodies that target enzymes in the mitochondria. Mitochondria are the primary energy producers of the body which are found in every cell. Antibodies are proteins in the blood that help destroy bacteria and other harmful pathogens. A small percentage of people with primary biliary cirrhosis don't have AMAs so a false positive test result is possible. Results are positive in about 95% of cases.
- Abdominal ultrasound - This is a non-invasive test which uses high frequency sound waves to create precise images of organs inside the body including the bile ducts which may be inflamed.
- Magnetic resonance imaging (MRI) and magnetic resonance elastography (MRE) – MRI is a noninvasive medical test that assists doctors in diagnosing and treating medical conditions. MRI uses a powerful magnetic field, radio frequency pulses and a computer to produce detailed pictures of organs, soft tissues, bone and virtually all other internal body structures without using x-rays. MRE is an imaging technique used to measure the elasticity of tissue by gently shaking the tissue in a magnetic resonance imaging (MRI) machine. MRE works by measuring the wavelength of the vibrations sent through the tissues. MRE technology works by combining traditional magnetic resonance imaging with low-frequency sound waves thereby possibly avoiding the need for a liver biopsy which is more invasive.
- Liver biopsy – This procedure entails the removal of a small sample of liver tissue through a small incision using a thin needle. The liver sample is then studied in a laboratory to confirm the diagnosis and/or the extent of the disease. A liver biopsy is invasive, costly and, is affected by sampling error.
American Liver Foundation, Primary Biliary Cirrhosis” http://www.liverfoundation.org/abouttheliver/info/pbc/ Retrieved September 7, 2011
Mayo Clinic, “Primary Biliary Cirrhosis” http://www.mayoclinic.com/health/primary-biliary-cirrhosis/DS00604 Retrieved September 7, 2011
MedicineNet.com, “Primary Biliary Cirrhosis” http://www.medicinenet.com/primary_biliary_cirrhosis/article.htm Retrieved September 7, 2011
Medscape Reference, “Primary Biliary Cirrhosis” http://emedicine.medscape.com/article/171117-overview Retrieved September 7, 2011<//p>
PubMed Health, “Primary Biliary Cirrhosis” http://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0001327/ Retrieved September 7, 2011
World Journal of Gastroenterology, “Clinical Features and Management of Primary Biliary Cirrhosis” http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2716586/?tool=pmcentrez Retrieved September 7, 2011