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MSRACLIN5-018

A 66 year old woman presents with fatigue, upper abdominal discomfort and itching. On examination, she has hepatomegaly, jaundice and hyperpigmentation. You request a liver screen blood test, which reveals that her ALT is 189 U/L (normal less than 50 U/L), AST is 174 U/L (normal less than 50 U/L), Alkaline Phosphatase is 757 U/L (normal range, 30-130 U/L), Anti-Smooth Muscle Antibody is negative, Anti-Mitochondrial Antibody is positive and Liver-Kidney Microsomal Antibody is negative.

What is the most likely diagnosis?

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