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June 1959

Cholangiolitic Hepatitis: Clinical-Pathologic Studies and Response to Steroid Therapy in Four Cases

Author Affiliations

U. S. Army

From the Medical Service, Second General Hospital, APO 180, New York. Dr. Hardin is now Assistant Professor of Medicine, College of Medical Evangelists, Los Angeles; present address: 8351 Doris St., San Gabriel, Calif.

AMA Arch Intern Med. 1959;103(6):859-870. doi:10.1001/archinte.1959.00270060011003

Introduction  A chronic form of hepatitis, which was predominantly obstructive, was originally recognized by Eppinger.1 Watson and Hoffbauer2 later used the term "cholangiolitic hepatitis" in referring to patients with a similar clinical picture. In addition, other reports,3-6 substantiated by epidemiological data, have indicated that acute viral hepatitis is capable of inducing an illness with clinical and laboratory features typical of regurgitation jaundice. In cholangiolitic hepatitis the clinical manifestation of a relative sense of well-being is in marked contrast to the biochemical abnormalities. There are usually an appreciable degree of pruritus (associated with acholic stools), low urinary urobilinogen, hyperbilirubinemia (high direct fraction), bilirubinuria, high alkaline phosphatase, and hypercholesteremia. This is in marked contrast to the relatively normal "flocculation" tests. A review of the previously described cases disclosed many with mildly abnormal hepatocellular tests, and the diagnosis of cholangiolitic hepatitis was used to indicate these predominant clinical and biochemical