Initial autoimmune labs included an ANA immunofluorescence assay (IFA) with a reflex titer, and anti-SMA and anti-mitochondrial antibody tests were ordered to evaluate for AIH and PBC, respectively [21-23]. The ANA IFA screen came back positive along with an ANA titer of 1:40 which is considered a positive result in adults [1]. The gene discussed is BTG3; the disease is primary biliary cholangitis.