It is also clear that the reasons that lead the clinician to perform a liver biopsy are limited. It can be useful to establish a diagnosis in patients who are AMA negative, to confirm the diagnosis even with positive AMA, to exclude concurrent diseases such as steatohepatitis or overlap syndromes PBC plus autoimmune hepatitis or PBC with primary sclerosing cholangitis, to stage and to monitor disease progression or response to treatment 17. In the early stages, changes are focused within the portal tracts. As the disease progresses we observe parenchymal effects of chronic cholestasis.
Las razones que llevan al clínico a realizar una biopsia hepática son limitadas, por lo que puede ser útil para establecer el diagnóstico en pacientes AMA negativos, confirmar la sospecha diagnóstica aún con AMA positivo, excluir enfermedades concurrentes como esteatohepatitis o síndromes de sobreposición CBP mas hepatitis autoinmune o CBP con colangitis esclerosante primaria, estadificar la enfermedad y monitorizar la progresión o la respuesta al tratamiento 17.