Hepatitis, colitis, and lupus manifestations
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1. An analysis has been made of eight cases in which hepatitis and ulcerative colitis occurred together. Current explanations of this association, including conditioned nutritional deficiency and portal toxemia causing liver damage, failed to account for all the features of our particular cases.
2. Of the eight patients, three had chronic hepatitis of uncertain pathogenesis and concurrent ulcerative colitis of varying severity and five others had, in addition, systemic lesions including nephritis, pleurisy, pericarditis, polyarthritis, and thrombocytopenic purpura.
3. Evidence for an auto-immune pathogenesis in these cases included elevated serum gamma globulin levels, positive L.E. cell tests in four cases, and positive “auto-immune complement fixation” reactions in six cases. Five patients responded well to cortisone. The dense lymphocytic aggregates seen in histological sections of affected tissues were also thought to be of significance.
4. This immunological disturbance may depend upon induced auto-antigenicity of some body component as a result of initial tissue damage—alternatively there may be a fundamental anomaly of antibody producing tissues.
KeywordsHepatitis Ulcerative Colitis Nephritis Purpura Cortisone
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