Active chronic hepatitis. Part I.

IN 1950 Waldenstrom first drew attention to the occurrence of a form of chronic liver disease in young people, predominantly adolescent girls, in whom there was moderate jaundice, enlargement of the liver and spleen, acne, amenorrhoea and hyperglobulinaemia. The occurrence of fever, arthralgia and Cushingoid features was noted (Kunkel et al 1951, Beam et al 1956), the LE cell phenomenon was reported (Joske and King 1955) and the condition was called lupoid hepatitis (Mackay et al 1956). Over the years it has been given many other names including liver disease in young women l(Beam et al 1956) with hypergammaglobulinaemia (Jones and Castleman 1962), active juvenile cirrhosis (Read et al 1963), plasma cell hepatitis (Page et al 1964), autoclastic lupoid hepatitis (Naish 1960) and autoimmune hepatitis ;(Mackay et al 1965), each emphasising particular pathological or clinical features. In recent years the term active chronic hepatitis has gained general acceptance because it embodies two of the essential pathological and clinical features of the disorder, namely its chronic and therefore usually progressive nature and the activity of the process typically manifested by the recurring episodes of hepatitis which punctuate its course. Lately Sherlock (1975), with a view to further refining the nomenclature of chronic hepatitis, has proposed that the classical type be called active chronic "lupoid" (HBAg negative) hepatitis.