ATP8B1 and adrenal cortex carcinoma: Cryptogenic cholestasis (ACC), defined as γGT and/or ALP persistently > 1.5-fold the upper normal values in at least two tests or as a history of pruritus combined with elevated BAs (10 μmol/l) for more than 6 months, occurs in patients of different ages; after excluding other causes of the disease, it is feasible to explore the existence of mutations linked to PFIC in adults with adult-onset cryptogenic cholestasis (ACC) [21].