Simultaneous nephrotic syndrome and hepatitis in secondary syphilis: case report and review of the literature

Ishiwatari, Ayumi; Hasegawa, Jumpei; Hoshino, Yoshie; Kaga, Toshie; Y, Abe; Wakai, Sachiko

doi:10.1007/s13730-015-0173-2

Cited by 11 publications

(8 citation statements)

References 19 publications

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“…However, in the present case of syphilis nephropathy, not only C1q but also IgG1, IgG3, and IgG4 among the IgG subclasses were positive. and similar positive results for C1q and IgG3 were also reported by Ishiwatari et al (9). There have been other reports of positive results for C1q, although no analysis focusing on IgG subclasses has been performed (5).…”

Section: Discussionsupporting

confidence: 84%

“…The lack of spike formation is a common feature in light microscopy. Since the onset of leg edema and proteinuria often occurs within one week to three months after syphilis infection, it may take more time for the glomerular basement membrane to elongate over the subepithelial deposits, which may not result in spike formation (5,9). This may explain why MN with spike formation has a long chronic course before the diagnosis is confirmed, whereas MN caused by syphilitic nephropathy has a short, acute course before the diagnosis is confirmed.…”

Section: Discussionmentioning

confidence: 99%

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Syphilis-related Membranous Nephropathy in a 35-year-old Woman

Nakayama,

Yamanouchi,

Mizuno

et al. 2024

Intern. Med.

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A 35-year-old woman was admitted for the examination of lower leg edema and proteinuria. A kidney biopsy showed membranous nephropathy (MN) with fine granular deposits of IgG along the glomerular capillary and poor spike formation, differing from primary MN in the presence of positive IgG3 and C1q. Lupus nephritis was excluded because serum complement and anti-dsDNA antibody, anti-Smith antibody, and anticardiolipin antibody tests were negative. The serological test for syphilis was positive, as was the Treponema pallidum hemagglutination test. The patient was diagnosed with syphilis, and the proteinuria disappeared with antibiotic treatment. In MN with positive IgG3 and C1q, syphilis nephropathy may be a differential diagnosis.

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Section: Discussionsupporting

confidence: 84%

Section: Discussionmentioning

confidence: 99%

Syphilis-related Membranous Nephropathy in a 35-year-old Woman

Nakayama,

Yamanouchi,

Mizuno

et al. 2024

Intern. Med.

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“… 17 , 18 Notably, patients with syphilitic nephropathy may also concurrently develop acute hepatitis. 19 - 23 Given the possibility of deranged hepatic function, liver function testing is important. Furthermore, a detailed clinical history, especially information regarding safer sex practices, is pertinent in these patients.…”

Section: Discussionmentioning

confidence: 99%

Membranous Glomerulonephritis as an Uncommon Presentation of Secondary Syphilis: A Reminder on Therapeutic Decision-Making in Clinical Practice

Inayat

Almas

Bokhari

et al. 2020

Journal of Investigative Medicine High Impact Case Reports

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Membranous glomerulonephritis is one of the common causes of nephrotic syndrome in the adult population. It is idiopathic in the majority of patients, but the secondary forms can be seen in the setting of autoimmune disease, cancer, infection, and following exposure to certain medications. However, subclinical syphilis-related membranous nephropathy remains a particularly rare clinicopathologic entity in modern times. In this article, we chronicle an interesting case of latent syphilis masquerading as membranous glomerulonephritis, which resolved with benzathine penicillin without requiring immunosuppressive treatment. We further supplement this paper with a concise review of the relevant literature that delineates the utility of appropriate antibiotic therapy in the management of luetic membranous nephropathy. Clinicians should remain cognizant of secondary syphilis while evaluating patients for possible glomerulonephritis or those presenting with proteinuria. Additionally, patients with hepatitis B, hepatitis C, and human immunodeficiency virus infections are not infrequently coinfected with Treponema pallidum. Therefore, a high index of suspicion for systemic manifestations of syphilis such as nephrotic syndrome is warranted in the setting of a coinfection. Prompt diagnosis and treatment of syphilis may result in resolution of proteinuria, without the need for standard immunosuppressive therapy commonly used in clinical practice.

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“…Despite the liver and kidney can be affected due to secondary syphilis, a concomitant involvement of both organs is an extremely rare finding and has been reported only a few times before 10 14–16. Differential diagnosis of concomitant syphilis hepatitis and nephrotic syndrome include hepatitis B infection, drug-induced, autoimmune and vascular etiologies 5 13–16…”

Section: Discussionmentioning

confidence: 99%

Cholestatic hepatitis with concomitant nephrotic syndrome due to late syphilis in an immunocompetent 32-year-old man

et al. 2020

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A 32-year-old man was referred to our clinic for evaluation of abnormal liver function tests and concurrent proteinuria. Physical examination revealed a maculopapular rash, involving the trunk and palms, and multiple ‘moth-eaten’ patches of alopecia. After a prolonged diagnostic work-up a hepatitis with concomitant nephrotic syndrome due to secondary syphilis was diagnosed. Treatment with benzylpenicillin led to complete clinical recovery. Syphilis is a re-emerging infectious disease with heterogeneous clinical presentation that should be considered in the differential diagnosis of inexplicable simultaneous liver and kidney dysfunction in patients with high-risk sexual behaviour.Syphilis is a re-emerging infectious disease with heterogeneous clinical presentation that should be considered in the differential diagnosis of inexplicable simultaneous liver and kidney dysfunction in patients with high-risk sexual behaviour.

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Simultaneous nephrotic syndrome and hepatitis in secondary syphilis: case report and review of the literature

Cited by 11 publications

References 19 publications

Syphilis-related Membranous Nephropathy in a 35-year-old Woman

Syphilis-related Membranous Nephropathy in a 35-year-old Woman

Membranous Glomerulonephritis as an Uncommon Presentation of Secondary Syphilis: A Reminder on Therapeutic Decision-Making in Clinical Practice

Cholestatic hepatitis with concomitant nephrotic syndrome due to late syphilis in an immunocompetent 32-year-old man

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