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Answer 4
  1. AMA. A positive serum AMA assay would essentially confirm the diagnosis of PBC. Sensitivity and specificity for PBC in the setting of a positive AMA are both greater than 95%.1 Antinuclear antibody is often positive in autoimmune hepatitis; however, the patient does not have biochemical evidence of hepatitis. Serum amylase would be elevated in patients with acute pancreatitis but normal in PBC. Antigliadin antibody would be elevated in patients with celiac disease but not in PBC. IgG subclass 4 may be elevated in patients with autoimmune pancreatitis.

    Van de Water J, Cooper A, Surh CD, et al. Detection of autoantibodies to recombinant mitochondrial proteins in patients with primary biliary cirrhosis. N Engl J Med 1989;320:1377-80.

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