Abstract Review With Dr. Morales

Clinical Vignettes

In this video, Ana Maria Davila, a third-year internal medicine resident at Rush University Medical Center, shares the findings of a recent research abstract focused on diagnostic delays in Primary Biliary Cholangitis (PBC). Conducted in collaboration with her mentor, the retrospective study reviewed 163 patients with AMA-positive PBC and found that the average time from initial symptom onset or alkaline phosphatase elevation to diagnosis was approximately three years. To better understand patterns of delay, the team developed a diagnostic scoring system based on sex, age, presence of pruritus, and elevated alkaline phosphatase levels. Alarmingly, patients with only 2–3 diagnostic indicators experienced the longest delays—up to two years on average. Additionally, a review of 12,000 female patients over 40 revealed that AMA testing and hepatology referrals were significantly underutilized, with only 12.4% receiving AMA tests and just 9% being referred to hepatology. This study highlights the critical need for improved medical education and awareness of PBC—not just within hepatology, but across primary care, rheumatology, and dermatology. Early recognition and referral can prevent progression to cirrhosis and improve long-term outcomes in this underdiagnosed autoimmune liver disease.