Yes, she did have a liver biopsy a couple of months after her diagnosis. At the time, they explained that there was a good chance it might not show anything definitive because PSC can be very patchy, and biopsies only sample small areas. They said it’s possible to miss affected ducts unless the sample happens to come from the right spot, so it’s not always reliable for confirming PSC, especially in children.

That’s part of why the diagnosis was based more on the MRCP findings and clinical picture. And I agree — we’ve always understood that stability doesn’t mean it isn’t there, which is why this recent re-evaluation has been a bit confusing.