S1860 Diffuse Large B Cell Lymphoma Presenting as Acute Recurrent Pancreatitis

Abstract

Discussion: A rare presentation of syphilis is with liver manifestations. Syphilis can easily be confused with PBC, with an isolated elevation of alkaline phosphatase, and AMA. This is an important consideration when making the diagnosis of PBC. Syphilis should be considered greater in patients with history of multiple sexual partners, patients with HIV, or other sexually transmitted diseases. The patient in this case had complained of joint pain and rash which were thought to be an unrelated rheumatologic condition given improvement with steroids. Alkaline phosphatase was presumed to be artificially decreased secondary to the steroids before starting Ursodiol. Treatment of the underlying syphilis normalized lab values. This case demonstrates the need to consider syphilis in the differential diagnosis of patients presenting with suspected PBC, especially male patients with no history of other autoimmune diseases.