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March 1959

The Use of Adrenal Steroids in Subacute and Chronic Cholangiolitic Hepatitis: A Clinico pathologic Correlation

Author Affiliations


Department of Medicine, The University of Chicago.

AMA Arch Intern Med. 1959;103(3):354-368. doi:10.1001/archinte.1959.00270030010002

Introduction  Cholangiolitic hepatitis is a syndrome of varied etiology characterized by jaundice, pruritus, enlarged liver and spleen, and increased serum alkaline phosphatase and cholesterol. In some cases the onset of this syndrome can be traced to a viral type of hepatitis,1-3 to drugs,4 or to poisonous substances.5 In other cases the etiology remains unknown. The parenchymal cells of the liver may be little affected, and important changes occur in the portal triads. The intralobular and perilobular bile canaliculi and ductules contain bile thrombi, and pericholangiolitis further complicates the histological picture. In protracted cases the differential diagnosis from extrahepatic biliary obstruction may be very difficult. Knowledge of this syndrome has increased, and liver biopsy has been helpful in avoiding unnecessary abdominal explorations. The management of chronic and recurrent cholangiolitic hepatitis has been a major problem. In some cases corticotropin (ACTH) and adrenocorticosteroids seemed of value. This paper