Antimitochondrial antibodies are strongly associated with which liver condition?

• A. Autoimmune hepatitis
• B. Celiac disease
• C. Primary biliary cirrhosis
• D. Goodpasture's syndrome

Answer: (C)

Antimitochondrial antibodies are most strongly linked to autoimmune cholestatic liver disease, specifically primary biliary cirrhosis (primary biliary cholangitis). These antibodies target components of the mitochondrial pyruvate dehydrogenase complex and are found in the vast majority of patients with this condition, making AMA a highly characteristic serologic marker. The disease involves immune-mediated destruction of small intrahepatic bile ducts, leading to cholestasis and progressive liver damage. AMA are not typical for other listed conditions—celiac disease is associated with anti-endomysial and anti-tTG antibodies, Goodpasture’s with anti-GBM antibodies, and autoimmune hepatitis with anti-smooth muscle antibodies or ANA—so the strongest association is with primary biliary cirrhosis.