22nd April 2024

A 38-year-old nurse with Sjogren’s presents with general malaise and itching of her skin

A 38-year-old nurse with Sjogren’s presents with general malaise and itching of her skin. There is no history of recent travel, and she has not taken any new medications. The examination is unremarkable, aside from some scratch marks due to itching. Bloods showed the following:


Bilirubin	28 μmmol	Anti-mitochondrial Antibodies	Positive
Alkaline Phosphatase	450 μmmol	Anti-smooth muscle antibodies	Negative
ALT	45 μ/l


Anti-HBs	Positive
HBsAg	Negative
HBcAg	Negative
HCV	Negative

Which of the following is the most likely diagnosis?

Select the SINGLE most appropriate option from the list below. Select ONE option only.

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