A middle-aged woman with severe pruritus, jaundice, hepatomegaly and a cholestatic pattern (ALP well above the modest rise in AST/ALT, conjugated hyperbilirubinaemia) fits primary biliary cholangitis (cirrhosis). The next step would be antimitochondrial antibody (AMA) testing. Primary sclerosing cholangitis is also cholestatic, but it is typically seen in men with ulcerative colitis. Wilson's disease and chronic hepatitis C give a hepatocellular, not cholestatic, picture.