A 32-year-old woman comes to the physician for a 2-month history of generalized pruritis. She has history of subacute granulomatous thyroiditis. Her brother has rheumatoid arthritis. Ultrasound of the abdomen shows a stone in the gall bladder. Laboratory studies show:
Hemoglobin 10 g/dL
Serum total bilirubin 3.0 mg/dL
Serum alkaline phosphatase 300 IU/L
Serum total cholesterol Elevated
Serum amylase Normal
Which of the following is the most likely diagnosis?
Biliary cirrhosis
Cholangitis (ascending)
Cholangitis (primary sclerosing)
Cholecystitis
Dubin-Johnson syndrome
Gilbert syndrome
