[Intrahepatic cholangitis with presumably immunologic bases]

An overview is given on three topics of chronic cholangitides, namely 1. chronic non destructive cholangitis, i.e. primary biliary cirrhosis, 2. immunocholangitis, 3. primary sclerosing cholangitis including the liver-colitis-syndrome, each of which will lead into primary biliary cirrhosis within a commonly long period. The histological patterns are well defined in chronic non destructive cholangitis and primary sclerosing cholangitis. Clinical features, laboratory data and histologic pattern concerning the immunocholangitis will have to be evaluated in more precise ways in the future. As with all immunological diseases it is not always clear whether findings are causative or merely secondary consequences of the disease in question. Nevertheless compelling evidence for an immunologically related pathogenesis comes from immunohistochemical studies. Results of electronmicroscopic and histochemical studies of basement membranes in sclerosing cholangitis did not refer to their considerable role in the initiation of the disease. The role of vascular lesions in bile duct destruction and scar formation seems to be negligible. Neoformation of ducts and duct like structures which regularly precede fibre formation are the consequence of hepatocellular metaplasia.