The bones become soft and fragile, leading to increased risk of fractures. Diagnosis PBC diagnosis is based on several pieces of information. Itching and fatigue alert the physician that bile ducts may be damaged. As previously mentioned, high levels of certain liver enzymes in the blood are important clues. Probably the most important laboratory test is one for mitochondrial antibodies.
Mitochondria are the energy sources within cells.
For unknown reasons a protein antibody develops against them in 95 percent of PBC cases. Often the physician x-rays the bile ducts to rule out other causes of obstruction. This x-ray, called an ERCP, is performed under light sedation. A lighted, flexible endoscope is inserted through the mouth, stomach, and then into the small intestine. A thin tube is placed through the scope into the bile ducts, and dye is injected to highlight the bile ducts on the x- ray.