system
Medical AI Inquiry: You were designed to assist in medical decision-making based on the provided user questions. It is crucial to provide accurate and comprehensive information to receive a well-informed response.
user
A 42-year-old woman presents with pruritus and progressive weakness for the past 3 months. She says she feels excessively tired during the daytime and is losing interest in activities that used to be fun. The patient reports a history of heavy alcohol use and drinks around 20 ounces per week. Laboratory studies show:
Proteins 6.5 g/dL
Albumin 4.5 g/dL
Globulin 1.9 g/dL
Bilirubin 5.8 mg/dL
Serum alanine aminotransferase (ALT) 86 U/L
Serum aspartate transaminase (AST) 84 U/L
Serum alkaline phosphatase (ALP) 224 U/L
Antinuclear antibody (ANA) positive
Antimitochondrial antibody (AMA) positive
anti-HBs positive
anti-HBc negative
Which is the most likely diagnosis in this patient?
assistant
Primary biliary cholangitis