Details

Autor(en) / Beteiligte

• Mistilis, Steven P.
• Blackburn, C.R.B.

Titel

Active chronic hepatitis

Ist Teil von

• The American Journal of Medicine, 1970-01, Vol.48 (4), p.484-495

Ort / Verlag

United States: Elsevier Inc

Erscheinungsjahr

1970

Quelle

Elsevier Journal Backfiles on ScienceDirect (DFG Nationallizenzen)

Beschreibungen/Notizen

• Analysis of data from eighty-six patients with active chronic hepatitis who have been followed for up to nineteen years together with a comprehensive survey of the literature forms the basis for this review of the natural history of this disease. This review was written with the following questions in mind: (1) What is meant by the term “active chronic hepatitis?” (2) How is active chronic hepatitis recognized and treated in patients? (3) What is the prognosis of the disease? (4) What is the cause and nature of active chronic hepatitis? The onset, clinical course, morbidity, mortality, prognosis, systemic manifestations and endocrine changes of the disease are examined in detail. Abnormalities of hepatic function tests and hematologic changes are outlined and the significance of abnormal tissue antibody reactions and serologic tests in active chronic hepatitis is discussed. The importance of aspiration liver biopsy as the only reliable means of early diagnosis and for differentiating the disease from other clinically related disorders is stressed. Data concerning diagnostic changes at onset, patterns of liver injury as the disease progresses and the histogenesis of cirrhosis were obtained from studies of 150 liver biopsy sections. Features permitting differentiation of active chronic hepatitis from acute infectious hepatitis, persistent hepatitis, pericholangitis, primary biliary cirrhosis, alcoholic liver disease and cryptogenic cirrhosis are discussed in detail. Our experience with the use of corticosteroids, 6-mercaptopurine and azathioprine in the treatment of active chronic hepatitis is summarized and a suggested regimen for the management of the disease outlined. The cause or causes of the disease with particular regard to an altered immune reaction or possible viral etiology is reviewed.