Screening and diagnosis

Classification and risk stratification

Perioperative care

Quality improvement

Patient education

Nonpharmacologic interventions

Therapeutic procedures

Respiratory support

Follow-up and surveillance

Specific circumstances

Preventative measures

Medical management

Surgical interventions

Inpatient care

Diagnostic procedures

Diagnostic investigations

Insufficient evidence to make a recommendation.

Strongly favor this test or intervention.

The diagnostic evaluation for primary biliary cholangitis involves analyzing various medical findings, and determining if the diagnostic criteria are met based on a logical assessment of these findings. The possibilities considered pivotal for establishing this diagnosis include:

- Biochemical evidence of cholestasis demonstrated by an elevation in alkaline phosphatase.
- Detection of antimitochondrial antibodies.
- Discovery of primary biliary cholangitis-specific autoantibodies, such as anti-SP100 or anti-GP210.
- Histological evidence from a biopsy showing nonsuppurative destructive cholangitis and the destruction of interlobular bile ducts.

The computation interprets these findings and concludes whether the diagnostic criteria are fulfilled based on specific pairings:

- The presence of both biochemical evidence of cholestasis and antimitochondrial antibodies indicates the criteria are met.
- Biochemical evidence of cholestasis combined with histologic findings of cholangitis and bile duct destruction also meets the criteria.
- A conjunction of antimitochondrial antibodies and the abovementioned histologic findings establishes the criteria.
- Biochemical evidence coupled with primary biliary cholangitis-specific autoantibodies satisfies the criteria.
- Lastly, primary biliary cholangitis-specific autoantibodies alongside the histological evidence mentioned confirms meeting the diagnostic criteria.

If any of these pairs are identified in the assessment, the output is "Diagnostic criteria are met." If none of these combinations are observed, then it is determined that "Diagnostic criteria are not met." 

Understanding these conditions and associations allows for an effective determination of the presence of primary biliary cholangitis based on clinical data interpretation.

The calculator in question is the Diagnostic Criteria for Primary Biliary Cholangitis (PBC). This diagnostic tool is used specifically for patients suspected of having primary biliary cholangitis, a chronic disease that destroys the bile ducts in the liver. 

The clinical utility of this calculator is to aid in the diagnosis of PBC. It uses a combination of biochemical evidence of cholestasis (primarily elevated alkaline phosphatase), presence of anti-mitochondrial antibodies (AMAs), and histological evidence of nonsuppurative destructive cholangitis and destruction of interlobular bile ducts. 

The diagnosis of PBC is made when two of the three criteria are present. This calculator is not applicable to patients without signs of liver disease or those with other types of liver diseases. It should also be noted that while the presence of AMAs is highly specific for PBC, they can also be found in a small percentage of patients with other liver diseases or autoimmune disorders.

Diagnostic criteria for primary biliary cholangitis

Primary biliary cholangitis

Management of fatigue

Laboratory tests

Clinical audit

Diagnostic criteria

First-line therapy

Evaluation for osteoporosis

Liver transplantation

Liver transplantation, indications

Indications for referral

Surveillance for hepatocellular carcinoma

Surveillance for HCC

Pregnant patients

Patients with PBC/AIH overlap

Liver transplantation, post-transplant management

Calcium and vitamin D supplementation

Second-line therapy

History and physical examination

Setting of care

Management of pruritus

Management of ascites and hepatic encephalopathy

Management of osteoporosis

Management of vitamin deficiencies

Follow-up

Psychosocial support

Upper gastrointestinal endoscopy

Liver biopsy

Screening for comorbidities

Management of sicca symptoms

Abdominal ultrasound

Lifestyle modifications

Indications for screening

Liver elastography

Risk assessment

Management of dyslipidemia

Primary biliary cholangitis

Guidelines

Key sources