Intriguingly, some evidence suggests that AMA titers might be linked with disease severity in PBC patients, given that increasing serum levels of immunoglobulin M (IgM), alkaline phosphatase (alk-p), and γ-glutamyl transferase (γ-GT) and symptoms parallel increasing AMA titers (7), and the presence of immunoglobulin G (IgG)-AMAs seems to be a characteristic of PBC patients with more severe disease (8). Here, ALK is linked to primary biliary cholangitis.