During my consultation with a rheumatologist for my knee and finger arthritis my blood tests revealed antibodies against ANA 1:1240 with MND positivity in immunofluorescence as well as the positivity of 3 very highly specific pbc markers i.e. tantibodies against namely M2-3E, Sp-100 and PML but AMA negative and normal liver enzymes namely Alk. Phosphatase, GGT, AST, ALT and normal bilirubin and normal prothrombin time. Hence suspected PBC and started urso 500 mg daily to be gradually increased over 2 months to 1000 mg. But on being referred to Gastroenterologist for liver biopsy for confirmation of diagnosis and staging, he suggested stopping of urso and no liver biopsy with just checking on liver enzymes once every two years as according to him normal liver biochemistry means no active disease. But as i have been reading liver biochemistry gets altered only in late stages and urso is most effective when started early in disease. So should i stop taking urso especially without ruling out active disease with a liver biopsy. Please suggest regarding liver biopsy too besides continuing urso and further management. Thank you for your guidance.
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