Serum AP and γGT are commonly elevated and define, together with AMA, the diagnosis of PBC. Mildly elevated serum aminotransferases (ALT, AST) are usually observed in PBC but are not diagnostic. Increased serum levels of (conjugated) bilirubin as well as alterations in prothrombin time and serum albumin are late phenomena in PBC like in other cirrhotic states and unusual at diagnosis. However, serum bilirubin is a strong and independent predictor of survival [31] with a high impact on all established models for prognosis.