Case Study: Guess the disease

A 35 year old woman presented with fatigue, mild jaundice, and dark urine. Initially suspected as hepatitis but LFTs showed elevated alkaline phosphatase with normal ALT/AFT. Further workup revealed anti-mitochondrial antibodies.

Guess the final diagnosis.

The fatigue dark urine and jaundice are classics of cholestatic liver disease..
When ALT/AST is normal and alkaline phosphatase is elevated, it shows a cholestatic pattern only..
and when AMAs are high, its autoimmune and also suggestive of Biliary cholangitis.
Some people also develop pruritis.. and in the advanced case a liver transplant is advised.

Cholestatic liver disease often shows up with fatigue, jaundice, and raised ALP classic yet easy to miss early on. Positive anti-mitochondrial antibodies point toward Primary Biliary Cholangitis, where early detection can delay severe outcomes like transplant.

Primary Biliary Cholangitis