My wife is 27 y. We have a 8 months old baby. Since 2 month after every 10-15 days getting severe upper abdominal pain radiating towards back which lasts for more than 5-6 hours. Other symptoms include nausea, vomiting sometimes. next day itching also starts all over body. Had intrahepatic cholestasis of pregnancy from 2nd trimester while pregnant but symptoms subsided after delivery(1 week). Now 3-5 mm GB calculi detected in USG. SGPT, SGOT increased 10 times normal range,AP increased more than 5 times normal range. Total protein 8.64, Albumin 4.16, Globulin 4.48, ALB/GLB 0.93 PT, APTT, Bilirubin, reports are normal. Anti HCV, Anti HBcAb ANA, AMA- negative ASMA- positive but again ASMA negative after 4 days. After taking UDCA for 15 days SGPT, SGOT became normal but AP remained same. Is this liver issue or gall stone causing this? Or if both then what should be the treatment course sequence? I am worried can this be AIH ? Is there need for liver biopsy? Please advise.