Ans: d. Anti mitochondrial antibody

• The given history is that of a middle aged female with pruritis, elevated bilirubin levels, increased levels of serum alkaline phosphatase and gamma glutamyl transferase.
• Serum alkaline phosphatase and gamma glutamyl transferase are markers of cholestasis.
• The given biopsy shows florid duct lesions with portal based granulomatous inflammation.
• The histopathology of colonic biopsy is normal.
• The given condition is autoimmune condition – Primary biliary cirrhosis
• 90%  of the patient with this condition shows Antimitochondrial body.
• Few patients can show the presence of ANA and ANCA
• Primary biliary cirrhosis can be associated with Sjogren’s syndrome, scleroderma or thyroid disease.
• Antigliadin, anti endomysial and anti tissue transglutaminase  antibodies can be seen in Celiac disease
• Anti Saccharomyces cerevisiae antibody is present in patients with ulcerative colitis