CASE REPORT: Severe Cholestatic Hepatitis as the First Symptom of Secondary Syphilis

Ridruejo, Ezequiel; Mordoh, Ana; Herrera, Fabián; Avagnina, Alejandra; Mando, Oscar O.

doi:10.1023/b:ddas.0000042237.40205.c6

Cited by 27 publications

(21 citation statements)

References 3 publications

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“…In addition, histological features, including nonspecific portal inflammatory infiltrates, periportal hepatocyte necrosis, and pericholangiolar inflammation, were also consistent with syphilitic hepatitis reported previously (6,8). As in the present case, identification of spirochetes in liver biopsy specimens failed in the majority of published cases (5)(6)(7)9). There are various pathogeneses, such as direct portal venous inoculation and immune complex-mediated disease (6); however, given the rarity of detecting spirochetes in liver specimens, direct hepatotoxicity of the microorganism seems to be unlikely.…”

Section: Discussionsupporting

confidence: 86%

A Case of Syphilis Presenting with Initial Syphilitic Hepatitis and Serological Recurrence with Cerebrospinal Abnormality

et al. 2010

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We present the case of an immunocompetent 50-year-old Japanese man with a cerebrospinal fluid (CSF) abnormality relevant to syphilis; his original presentation was liver dysfunction, the etiology of which was uncertain until positive serology for syphilis was identified. Liver dysfunction was promptly resolved after oral penicillin therapy; however, serological recurrence developed. CSF abnormality associated with syphilis was confirmed by subsequent lumbar puncture. Syphilis should be included in the differential diagnosis of patients with liver dysfunction of unknown etiology, and possible neurosyphilis should be considered when the treatment becomes refractory, even when there is no evidence of neurological manifestations.

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Section: Discussionsupporting

confidence: 86%

A Case of Syphilis Presenting with Initial Syphilitic Hepatitis and Serological Recurrence with Cerebrospinal Abnormality

et al. 2010

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“…It usually occurs concomitant to the rash [4], but has also been reported to be the first manifestation of secondary syphilis [5]. Histological findings vary from mild portal inflammation to focal granulomatous hepatic inflammation.…”

Section: Discussionmentioning

confidence: 99%

Secondary syphilis after renal transplantation

Ballout¹,

Yombi

Hassoun

et al. 2008

Clinical Kidney Journal

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“…8 The exact mechanism of disease is unknown but it has been proposed that direct portal venous inoculation and immune complex-mediated processes may be involved. 9 As in this case, the pattern of liver enzymes found in syphilitic hepatitis often has a cholestatic pattern with a disproportionate elevation of alkaline phosphatase and a less prominent elevation of aminotransferases. One study of HIV-positive patients with syphilitic hepatitis showed alkaline phosphatase levels ranging from 234 to 1870 IU/L at time of diagnosis.…”

Section: Ikumi Suzuki Ms IV Nicholas Orfanidis Md Stephanie Molesmentioning

confidence: 53%