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Plasma-Cell Hepatitis, with Special Attention to Steroid Therapy

Plasma-Cell Hepatitis, with Special Attention to Steroid Therapy Abstract In 1956, Bearn, Kunkel, and Slater1 described a syndrome of chronic hepatic disease occurring predominantly in young girls and characterized clinically by amenorrhea, obesity, striae, arthralgia, skin rashes, and evidence of moderate or severe liver damage. Most of his patients showed a marked elevation in serum γ-globulin concentration, and liver biopsy specimens obtained early in the course of the disease revealed infiltration of the periportal areas with an inflammatory cell exudate that was predominantly made up of plasma cells. It is our purpose in this paper to describe our experience in the management, including steroid therapy, of patients who, we believe, fit into the above-mentioned syndrome. We will refer to this syndrome by the name "plasma-cell hepatitis" throughout the remainder of this paper. This name has the advantage of focusing attention on the unique aspect of this disease, that is, the plasma-cell infiltrate in the liver and the related References 1. Bearn, A. G.; Kunkel, H. G., and Slater, R. J.: The Problem of Chronic Liver Disease in Young Women , Am. J. Med. 21:3, 1956.Crossref 2. Gyorgy, P.; Stokes, J., Jr.; Smith, W. H., and Goldblatt, H.: Studies on the Use of Aureomycin in Hepatic Disease: II. The Effect of Aureomycin on Experimental Dietary Hepatic Necrosis . Am. J.M. Sc. 220:6, 1950.Crossref 3. McNeile, H. J., and Solomon, C.: Aureomycin in Acute Fulminant Hepatitis: Report on Successful Treatment in 3 Cases , New York J. Med. 50:1393, 1950. 4. Farquhar, J. D.; Stokes, J., Jr.; Whitlock, C. M.; Bluemle, L. W., and Gambescia, J. M.: Studies on the Use of Aureomycin in Hepatic Disease: III. A Note on Aureomycin Therapy in Hepatic Coma , Am. J.M. Sc. 220:166, 1950.Crossref 5. Goldbloom, R. S., and Steigmann, F.: Aureomycin Therapy in Hepatic Insufficiency , Gastroenterology 18:93, 1951. 6. Webster, J. J.: Adrenal Cortex in Liver Disease , Ann. Int. Med. 33:854, 1950.Crossref 7. Bluemle, L. W., Jr.; Sborov, V. M.; Stokes, J., Jr.; Gyorgy, P., and Neefe, J. R.: The Use of Adrenocorticotrophic Hormone in Chronic Liver Disease (3 Cases) , in Proceedings of the First Clinical ACTH Conference , New York, Blakiston Company (division of McGraw-Hill Book Company, Inc.), 1950, Vol. 1, p. 505. 8. Bongiovanni, A. M., and Eisenmenger, W. J.: Observations During the Administration of ACTH to Patients with Chronic Liver Disease , in Proceedings of the Second Clinical ACTH Conference , New York, Blakiston Company (division of McGraw-Hill Book Company, Inc.), 1951, Vol. 1, p. 390. 9. Bongiovanni, A. M., and Eisenmenger, W. J.: Adrenal Cortical Metabolism in Chronic Liver Disease , J. Clin. Endocrinol. 11:152, 1951.Crossref 10. Havens, W. P., Jr.; Myerson, R. M., and Carroll, I. N.: Effect of ACTH, Cortisone and Progesterone on Patients with Chronic Hepatic Disease , Metabolism 1:172, 1952. 11. Sborov, V. M.; Bluemle, L. W., Jr.; Neefe, J. R., and Gyorgy, P.: The Clinical Usefulness of ACTH and Cortisone in Liver Disease , Gastroenterology 28:745, 1955. 12. Carman, C. T., and Giansiracusa, J. E.: Effect of Steroid Therapy on the Clinical and Laboratory Features of Primary Biliary Cirrhosis , Gastroenterology 28:193, 1955. 13. Spellberg, M. A.: The Usefulness of Corticotropin and Corticoids in Patients with Liver Disease , Am. J. Gastroenterology 26:342, 1956. 14. Rifkin, H.; Marks, L. J.; Hammerman, D. J.; Blumenthal, M. J.; Weiss, A., and Weingarten, B.: Use of Corticotropin and Cortisone in Acute Homologous Serum Hepatitis , A.M.A. Arch. Int. Med. 89:32, 1952.Crossref 15. Colbert, J. W., Jr.; Holland, J. F.; Heissler, I., and Knowlton, M.: The Use of ACTH in Acute Viral Hepatitis , New England J. Med. 245: 172, 1951.Crossref 16. Thorn, G. W.; Forsham, P. H.; Frawley, T. F.; Hill, S. R., Jr.; Roche, M.; Staehelin, D., and Wilson, D. L.: The Clinical Usefulness of ACTH and Cortisone : (Pt. 3) , New England J. Med. 242:865, 1950.Crossref 17. Ducci, H., and Katz, R.: Treatment of Acute Hepatitis with Cortisone and Antibiotics , Gastroenterology 29:381, 1955. 18. Shane, S. J.; Gaum, A. R., and Gaum, D.: The Treatment of Acute Fulminant Hepatitis with Corticotropin and Cortisone , Canad. M.A.J. 73:965, 1955. 19. Ducci, H., and Katz, R.: Cortisone, ACTH and Antibiotics in Fulminant Hepatitis , Gastroenterology 21:357, 1952. 20. Spellberg, M. A.: Observations on the Treatment of Hepatic Coma , Gastroenterology 32: 600, 1957. 21. Zoeckler, S. J., and Hegstrom, G. J.: Cortisone in Decompensated Portal Cirrhosis: A Preliminary Report , Gastroenterology 24:30, 1953. 22. Brown, H.; Jager, B. V., and Tyler, F. H.: ACTH in Cirrhosis of the Liver , Am. J. Med. 10: 770, 1951.Crossref 23. Butt, H. R.; Comfort, M. W.; Power, M. H., and Mason, H. L.: Observations of the Effect of Cortisone Acetate on 2 Patients with Hepatic Disease , J. Lab. & Clin. Med. 37:870, 1951. 24. Williams, C. F., and Flink, E. B.: Corticotropin Therapy of Chronic Liver Diseases , J. Lab. & Clin. Med. 39:888, 1952. 25. Sklar, M., and Young, I. I.: Failure of ACTH and Adrenal Corticoids to Alter the Course of Hepatic Coma in Advanced Portal Cirrhosis , Am. J.M. Sc. 229:138, 1955. 26. Zoeckler, S. J.: Cortisone in Portal Cirrhosis: A Controlled Study , Gastroenterology 26: 878, 1954. 27. Capps, R. B.; Bennett, A. M.; Mills, E. H.; Ettinger, R. H.; Drake, M. E., and Stokes, J., Jr.: Infectious Hepatitis in Infants and Small Children , A.M.A. Am. J. Dis. Child. 89:701, 1955. 28. Klatskin, G.: Subacute Hepatic Necrosis and Postnecrotic Cirrhosis Due to Anicteric Infections with the Hepatitis Virus , Am. J. Med. 25: 333, 1958. 29. Eaton, M. D.; Murphy, W. D., and Hanford, V. L.: Heterogenetic Antibodies in Acute Hepatitis , J. Exper. Med. 79:539, 1944. 30. Gajdusek, D. C.: An "Autoimmune" Reaction Against Human Tissue Antigens in Certain Acute and Chronic Diseases: I. Serological Investigations , A.M.A. Arch. Int. Med. 101:9, 1958. 31. Mackay, I. R.; Taft, L. I., and Cowling, D. C.: Lupoid Hepatitis , Lancet 2:1323, 1956. 32. Heller, P.; Zimmerman, H. J.; Rozezgvaig, S., and Singer, K.: The L.E.-Cell Phenomenon in Chronic Hepatic Disease , New England J. Med. 254:1160, 1956. 33. Joske, R. A., and King, W. E.: The "L.E.-Cell" Phenomenon in Active Chronic Viral Hepatitis , Lancet 2:477, 1955. 34. Bettley, F. R.: The "L.E.-Cell" Phenomenon in Active Chronic Viral Hepatitis , Lancet 2:724, 1955. 35. Kofman, S.; Johnson, G. C., and Zimmerman, H. J.: Apparent Hepatic Dysfunction in Lupus Erythematosus , A.M.A. Arch. Int. Med. 95:669, 1955. 36. Bartholomew, L. G.; Hagedorn, A. B.; Cain, J. C., and Baggenstoss, A. H.: Hepatitis and Cirrhosis in Women with Positive Clot Tests for Lupus Erythematosus , New England J. Med. 259: 947, 1958. http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png A.M.A. Journal of Diseases of Children American Medical Association

Plasma-Cell Hepatitis, with Special Attention to Steroid Therapy

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Publisher
American Medical Association
Copyright
Copyright © 1960 American Medical Association. All Rights Reserved.
ISSN
0096-6916
DOI
10.1001/archpedi.1960.02070030290006
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Abstract

Abstract In 1956, Bearn, Kunkel, and Slater1 described a syndrome of chronic hepatic disease occurring predominantly in young girls and characterized clinically by amenorrhea, obesity, striae, arthralgia, skin rashes, and evidence of moderate or severe liver damage. Most of his patients showed a marked elevation in serum γ-globulin concentration, and liver biopsy specimens obtained early in the course of the disease revealed infiltration of the periportal areas with an inflammatory cell exudate that was predominantly made up of plasma cells. It is our purpose in this paper to describe our experience in the management, including steroid therapy, of patients who, we believe, fit into the above-mentioned syndrome. We will refer to this syndrome by the name "plasma-cell hepatitis" throughout the remainder of this paper. This name has the advantage of focusing attention on the unique aspect of this disease, that is, the plasma-cell infiltrate in the liver and the related References 1. Bearn, A. G.; Kunkel, H. G., and Slater, R. J.: The Problem of Chronic Liver Disease in Young Women , Am. J. Med. 21:3, 1956.Crossref 2. Gyorgy, P.; Stokes, J., Jr.; Smith, W. H., and Goldblatt, H.: Studies on the Use of Aureomycin in Hepatic Disease: II. The Effect of Aureomycin on Experimental Dietary Hepatic Necrosis . Am. J.M. Sc. 220:6, 1950.Crossref 3. McNeile, H. J., and Solomon, C.: Aureomycin in Acute Fulminant Hepatitis: Report on Successful Treatment in 3 Cases , New York J. Med. 50:1393, 1950. 4. Farquhar, J. D.; Stokes, J., Jr.; Whitlock, C. M.; Bluemle, L. W., and Gambescia, J. M.: Studies on the Use of Aureomycin in Hepatic Disease: III. A Note on Aureomycin Therapy in Hepatic Coma , Am. J.M. Sc. 220:166, 1950.Crossref 5. Goldbloom, R. S., and Steigmann, F.: Aureomycin Therapy in Hepatic Insufficiency , Gastroenterology 18:93, 1951. 6. Webster, J. J.: Adrenal Cortex in Liver Disease , Ann. Int. Med. 33:854, 1950.Crossref 7. Bluemle, L. W., Jr.; Sborov, V. M.; Stokes, J., Jr.; Gyorgy, P., and Neefe, J. R.: The Use of Adrenocorticotrophic Hormone in Chronic Liver Disease (3 Cases) , in Proceedings of the First Clinical ACTH Conference , New York, Blakiston Company (division of McGraw-Hill Book Company, Inc.), 1950, Vol. 1, p. 505. 8. Bongiovanni, A. M., and Eisenmenger, W. J.: Observations During the Administration of ACTH to Patients with Chronic Liver Disease , in Proceedings of the Second Clinical ACTH Conference , New York, Blakiston Company (division of McGraw-Hill Book Company, Inc.), 1951, Vol. 1, p. 390. 9. Bongiovanni, A. M., and Eisenmenger, W. J.: Adrenal Cortical Metabolism in Chronic Liver Disease , J. Clin. Endocrinol. 11:152, 1951.Crossref 10. Havens, W. P., Jr.; Myerson, R. M., and Carroll, I. N.: Effect of ACTH, Cortisone and Progesterone on Patients with Chronic Hepatic Disease , Metabolism 1:172, 1952. 11. Sborov, V. M.; Bluemle, L. W., Jr.; Neefe, J. R., and Gyorgy, P.: The Clinical Usefulness of ACTH and Cortisone in Liver Disease , Gastroenterology 28:745, 1955. 12. Carman, C. T., and Giansiracusa, J. E.: Effect of Steroid Therapy on the Clinical and Laboratory Features of Primary Biliary Cirrhosis , Gastroenterology 28:193, 1955. 13. Spellberg, M. A.: The Usefulness of Corticotropin and Corticoids in Patients with Liver Disease , Am. J. Gastroenterology 26:342, 1956. 14. Rifkin, H.; Marks, L. J.; Hammerman, D. J.; Blumenthal, M. J.; Weiss, A., and Weingarten, B.: Use of Corticotropin and Cortisone in Acute Homologous Serum Hepatitis , A.M.A. Arch. Int. Med. 89:32, 1952.Crossref 15. Colbert, J. W., Jr.; Holland, J. F.; Heissler, I., and Knowlton, M.: The Use of ACTH in Acute Viral Hepatitis , New England J. Med. 245: 172, 1951.Crossref 16. Thorn, G. W.; Forsham, P. H.; Frawley, T. F.; Hill, S. R., Jr.; Roche, M.; Staehelin, D., and Wilson, D. L.: The Clinical Usefulness of ACTH and Cortisone : (Pt. 3) , New England J. Med. 242:865, 1950.Crossref 17. Ducci, H., and Katz, R.: Treatment of Acute Hepatitis with Cortisone and Antibiotics , Gastroenterology 29:381, 1955. 18. Shane, S. J.; Gaum, A. R., and Gaum, D.: The Treatment of Acute Fulminant Hepatitis with Corticotropin and Cortisone , Canad. M.A.J. 73:965, 1955. 19. Ducci, H., and Katz, R.: Cortisone, ACTH and Antibiotics in Fulminant Hepatitis , Gastroenterology 21:357, 1952. 20. Spellberg, M. A.: Observations on the Treatment of Hepatic Coma , Gastroenterology 32: 600, 1957. 21. Zoeckler, S. J., and Hegstrom, G. J.: Cortisone in Decompensated Portal Cirrhosis: A Preliminary Report , Gastroenterology 24:30, 1953. 22. Brown, H.; Jager, B. V., and Tyler, F. H.: ACTH in Cirrhosis of the Liver , Am. J. Med. 10: 770, 1951.Crossref 23. Butt, H. R.; Comfort, M. W.; Power, M. H., and Mason, H. L.: Observations of the Effect of Cortisone Acetate on 2 Patients with Hepatic Disease , J. Lab. & Clin. Med. 37:870, 1951. 24. Williams, C. F., and Flink, E. B.: Corticotropin Therapy of Chronic Liver Diseases , J. Lab. & Clin. Med. 39:888, 1952. 25. Sklar, M., and Young, I. I.: Failure of ACTH and Adrenal Corticoids to Alter the Course of Hepatic Coma in Advanced Portal Cirrhosis , Am. J.M. Sc. 229:138, 1955. 26. Zoeckler, S. J.: Cortisone in Portal Cirrhosis: A Controlled Study , Gastroenterology 26: 878, 1954. 27. Capps, R. B.; Bennett, A. M.; Mills, E. H.; Ettinger, R. H.; Drake, M. E., and Stokes, J., Jr.: Infectious Hepatitis in Infants and Small Children , A.M.A. Am. J. Dis. Child. 89:701, 1955. 28. Klatskin, G.: Subacute Hepatic Necrosis and Postnecrotic Cirrhosis Due to Anicteric Infections with the Hepatitis Virus , Am. J. Med. 25: 333, 1958. 29. Eaton, M. D.; Murphy, W. D., and Hanford, V. L.: Heterogenetic Antibodies in Acute Hepatitis , J. Exper. Med. 79:539, 1944. 30. Gajdusek, D. C.: An "Autoimmune" Reaction Against Human Tissue Antigens in Certain Acute and Chronic Diseases: I. Serological Investigations , A.M.A. Arch. Int. Med. 101:9, 1958. 31. Mackay, I. R.; Taft, L. I., and Cowling, D. C.: Lupoid Hepatitis , Lancet 2:1323, 1956. 32. Heller, P.; Zimmerman, H. J.; Rozezgvaig, S., and Singer, K.: The L.E.-Cell Phenomenon in Chronic Hepatic Disease , New England J. Med. 254:1160, 1956. 33. Joske, R. A., and King, W. E.: The "L.E.-Cell" Phenomenon in Active Chronic Viral Hepatitis , Lancet 2:477, 1955. 34. Bettley, F. R.: The "L.E.-Cell" Phenomenon in Active Chronic Viral Hepatitis , Lancet 2:724, 1955. 35. Kofman, S.; Johnson, G. C., and Zimmerman, H. J.: Apparent Hepatic Dysfunction in Lupus Erythematosus , A.M.A. Arch. Int. Med. 95:669, 1955. 36. Bartholomew, L. G.; Hagedorn, A. B.; Cain, J. C., and Baggenstoss, A. H.: Hepatitis and Cirrhosis in Women with Positive Clot Tests for Lupus Erythematosus , New England J. Med. 259: 947, 1958.

Journal

A.M.A. Journal of Diseases of Children – American Medical Association

Published: Mar 1, 1960

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