This is quite an interesting case which presented with only 6weeks of history of tiredness and generalized itching; there were no fever or obstructive jaundice symptoms.

A substantial differential would be Autoimmune hepatitis, as both are considered autoimmune diseases of the liver; however, histological appearances could provide us with more clarity. Primary biliary cholangitis shows bile duct destruction (sometimes with granulomas), and autoimmune hepatitis shows prominent portal and lobular lymphoplasmacytic inflammation.

Laboratory test

Antimitochondrial antibodies were negative, anti-smooth muscle antibodies and liver/kidney microsomes antibodies were negative.