]> 2026-07-31T09:41:31+00:00 WBR0622 0 en Antimitochonrial antibodies levels '''Incorrect''' : Most anti-mitochondrial antibodies assays are almost as sensitive and specific for PBC as liver biopsy, but diagnostic confirmation always requires liver biopsy. Anti-smooth muscle antibodies and immunoglobin levels Serum LDL, VLDL and TG levels Liver biopsy Iron studies and genetic testing Primary Care Office A 40 year old female, comes to the office with complaints of fatigue, lethargy, malaise and pruritis for the past few weeks. She recently noticed hyperpigmentation of skin in her upper limbs. Her past history is insignificant and her family history is unremarkable. She has no recent travel exposure outside the country. She denies smoking, alcohol and drugs. Her menstrual cycles are irregular with increased duration of cycles. Her temperature is 36.7 C, blood pressure is 130/70 mmHg, pulse is 102/min and respiartions are 16/min. On examination there is no jaundice, but xanthelasmas and excoriations from scratches with hyperpigmentation are present on skin examination. Abdomen is soft and non-tender with no organomegaly. Other system examinations are normal . Her lab results shows Hb:7 g/dl, hematocrit : 33, Na:135 mEq/L, K: 3 mEq/L, Cl:104mEq/L, Bi: 24 mEq/L, BUN: 30 mg/dl, glucose:176 mg/dl, Mg:1mg/dl and Ca: 8mg/dl. The liver fuction test results are as follows: Alanine aminotransferase : 100 U/L Aspartate aminotransferase : 90 U/L Alkaline phosphatase : 480 U/L Total bilirubin : 1 mg/dl Direct bilirubin : 0.6 mg/dl Hepatits A IgM : negative HbsAg : negative HBc Antibody : negative HCV Antibody : negative Which is the best diagnostic step to confirm the diagnosis in this patient ? D Gastrointestinal 2020-10-28T01:12:33Z 2459150.5503819 WBR0622