I have been diagnosed with PBC and started taking Urso 300mg 3 times a day. My question is how do I know for sure if it is PBC? My biopsy report said that I have granulomatous duct injury suggestive of PBC but that there are clinical and histologic features that are atypical for that disease. I had a normal ALP, ,mildy elevated ALT/AST but an AMA positive 1:640, an absence of keratin 7 positive cholestatic hepatiocytes, only rare loss of bile ducts in portal tracts without granulomas and persistence of canal of hiring/ductular profiles. The report goes on to say that granulomatous mimics of PBC should be considered clinically, including sarcoidosis and drug/toxin induced liver injury. So I took ACE blood test and I was in normal range so that ruled out sarcoidosis. Gastro feels it is definitely PBC but I keep having doubts because of the some of the info in the above report. Any advice would be greatly appreciated.