Review Question - QID 214211

A 44-year-old woman with a history of celiac disease presents to her primary care physician complaining of fatigue that she first noticed 6 months ago. Her fatigue has progressed over the last 6 months to the point that she is no longer able to tolerate exercise. She has also noticed increased itchiness during the past month. Her temperature is 98.0°F (36.7°C), blood pressure is 110/65 mmHg, pulse is 72/min, respirations are 14/min, and BMI is 33.7 kg/m^2. On exam, there is no scleral or sublingual icterus. Her abdomen is soft, non-tender, and mildly distended with a negative Murphy sign. The liver edge is palpable 10 cm below the costal margin, and the spleen tip is not palpable. There are minor excoriations on skin exam. Laboratory results are shown below:

Alkaline phosphatase: 930 U/L
Gamma-glutamyltransferase (GGT): 73 U/L
Total bilirubin: 1.6 mg/dL
Aspartate aminotransferase (AST): 80 U/L
Alanine aminotransferase (ALT): 90 U/L
Albumin: 4.1 g/dL
Prothrombin time: 11 seconds
Cholesterol: 480 mg/dL

Anti-nuclear antibodies: Negative
Anti-smooth muscle antibodies: Negative
Anti-mitochondrial antibodies: Positive

Which of the following is the most likely diagnosis?