What are the symptoms of PBC?

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The most common early symptoms:

Tiredness (fatigue) is often the first symptom to develop. It can be quite a disabling type of tiredness. The reason PBC causes tiredness is not clear.
Itch is a common symptom, but does not always occur. It is sometimes severe and distressing with the whole skin feeling itchy. The cause of the itch is not clear. It may be due to a chemical from the bile which builds up in the bloodstream.
Discomfort over the liver (upper right of abdomen) occurs in about one in five cases.
Red or pink blotchiness of the hands may develop.

When a doctor examines you, he or she may feel that your liver is enlarged. As the disease progresses jaundice (yellowing of the skin) develops. This is due to a build-up of bilirubin (a chemical in bile) which builds up in the bloodstream.
If cirrhosis develops, other liver-related symptoms are likely to develop. (See separate leaflet called 'Cirrhosis'.)

Some people with PBC have no symptoms

PBC is sometimes diagnosed by chance when blood tests that are done for other reasons show abnormalities which are due to PBC. Some of these people never develop symptoms. However, many of these people will develop symptoms at some point as the disease progresses.

Symptoms of related disorders

As mentioned, some people with PBC also have other autoimmune diseases. Therefore, symptoms related to these other diseases also occur in some cases. For example, a dry mouth and dry eyes are the main symptoms of Sjogren's syndrome.

Symptoms from complications

The risk of developing osteoporosis is increased in women with PBC. (See separate leaflet called 'Osteoporosis'.) Other complications related to disordered function of the liver develop in some cases. For example, problems with the kidneys and pancreas. Liver cancer is an uncommon complication.

How is PBC diagnosed?

Blood tests

If PBC is suspected from the symptoms, a blood test will usually confirm the diagnosis. Most people with PBC have:

A high level of certain liver enzymes (chemicals) in the bloodstream. (See separate leaflet called Liver Function Tests'), and...
An antibody called antimitochondrial antibody. This antibody may have something to do with causing the disease as it 'attacks' part of cells called mitochondria.

Liver biopsy

A liver biopsy is when a small sample of tissue is removed from a part of the liver. The sample is then examined under the microscope to look for abnormal cells. Typical changes seen under the microscope from the biopsy sample can confirm the diagnosis of PBC. The biopsy can also give an indication of the severity. For example, if cirrhosis is present, and if so, how badly. (See separate leaflet called 'Liver Biopsy'.)