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Primary biliary cholangitis (PBC), at one time called primary biliary cirrhosis, is an autoimmune condition in which the bile ducts in the liver are slowly destroyed by an immune attack. When the bile ducts are damaged, bile can back up in the liver and sometimes lead to irreversible scarring of liver tissue (cirrhosis). There is evidence that a combination of genetic and environmental factors triggers the disease. Up to 50% of people with PBC do not have any noticeable symptoms. PBSC is most commonly diagnosed in middle aged females who develop progressively severe itchiness. Medications can slow the liver damage, especially if treatment begins early. One of the more specific blood tests to help confirm the diagnosis of PBC is the detection of antibodies to the mitochondria and other components in cells.