A 45-Year-Old Woman Comes to the Office for Progressive Itchiness

A 45-year-old woman comes to the office for progressive itchiness and fatigue.  She also notes yellowing of the eyes and skin.  Physical examination shows scleral icterus, multiple excoriations on both the upper and the lower extremities, and hepatomegaly.  Laboratory results are as follows: Liver biopsy reveals dense lymphocytic infiltration of the portal triads, as well as granulomatous destruction of interlobular bile ducts.  Which of the following is the most likely diagnosis?

A) Acute hepatitis B
B) Autoimmune hepatitis
C) Primary biliary cholangitis
D) Primary sclerosing cholangitis
E) Sarcoidosis

Correct Answer:

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