Syphilis Hepatitis Presenting as a Mimic of Primary Biliary Cholangitis

Kern, Cody; Elmoursi, Ahmed; Blake, Caroline; Hoellein, Andrew R.

doi:10.14309/crj.0000000000000497

Cited by 5 publications

(5 citation statements)

References 13 publications

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“…A case of syphilis hepatitis mimicking PBC was described by Kern et al In their case, a positive AMA was seen, which also turned negative after treatment for syphilis [ 11 ]. While our patient had an equivocal result, this was likely elevated due to syphilis involvement of the liver.…”

Section: Discussionmentioning

confidence: 99%

The Great Mimicker Gets Caught: A Rare Case of Syphilis in the Gastrointestinal Tract

Cantu Lopez,

Herrera-Gonzalez,

Shamoon

et al. 2024

Cureus

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Syphilis is a sexually transmitted disease that impacts multiple organ systems and can mimic various diseases and is an extremely rare cause of proctitis in men who have sex with men and transgender females. We present a case of a 49-year-old transgender female with a medical history significant for diabetes mellitus and hyperlipidemia who presented to the emergency department with dull abdominal pain in the left upper and lower quadrants for two days. She had non-bloody, nonbilious emesis, 10-pound weight loss over 1 month, and constipation for 2 weeks. Laboratory results showed a cholestatic pattern. Computed tomography of the abdomen showed rectal wall thickening, multiple enlarged perirectal adenopathy, and mild inflammatory infiltration around the rectum suggesting superimposed proctitis. On colonoscopy, a possible rectal mass or severe proctitis with near complete obstruction was seen with initial pathology concerning for lymphoma or a rare type of colitis. The patient was empirically started on ceftriaxone and doxycycline leading to improvement in inflammation. Special stains requested were positive for Treponema pallidum confirming the diagnosis of syphilitic proctitis and highly suggestive syphilitic hepatitis. Few cases of syphilitic proctitis imitating rectal malignancy and syphilitic hepatitis have been reported. Syphilis requires exclusion as well as confirmation of spirochetes for high-risk populations with special staining. It is important to diagnose syphilis in special populations that are at high risk of contraction.

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Section: Discussionmentioning

confidence: 99%

The Great Mimicker Gets Caught: A Rare Case of Syphilis in the Gastrointestinal Tract

Cantu Lopez,

Herrera-Gonzalez,

Shamoon

et al. 2024

Cureus

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“…Our case presented a patient with primarily dermatologic complaints whose evaluation led to the diagnosis of syphilitic hepatitis. Rashes and dermatologic lesions are more often reported as painless and non-pruritic [ 1 - 4 , 8 , 9 ]. Sparse cases reported pruritic rashes but not subjective pain [ 4 , 10 ].…”

Section: Discussionmentioning

confidence: 99%

When the Sailor’s Handshake Fails: A Case of Syphilitic Hepatitis in an HIV Patient With Nonspecific Liver Biopsy and Atypical Cutaneous Presentation

Dawson¹,

Zhang²,

Salahi³

et al. 2022

Cureus

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Secondary syphilis has variable systemic manifestations, impersonating the presentation of more common pathologies, deceiving clinicians, and creating a difficult-to-diagnose patient. The case discussed combines hepatic syphilis with an uncommon syphilitic dermatologic presentation in a patient with HIV and a history of hepatitis A and B. Due to the challenge of diagnosis, the relative ease of confirming the diagnosis with serological assays, and reversibility of hepatic injury, the inclusion of syphilitic hepatitis on a differential diagnosis of hepatitis is warranted.

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“…Miyakawa et al demonstrated that false-positive reactions to the PBC-specific anti-M2 AMA reactions could occur with hepatitis A, Syphilis, and rheumatoid arthritis [9]. In addition, Kern et al showed a return to a negative anti-M2 AMA titer after recovery from Syphilis that was previously not reported [10].…”

Section: Case Presentationmentioning

confidence: 97%

Сase report of syphilitic hepatitis

Aginbay,

Khamzina,

Zhambulayev

et al. 2023

J CLIN MED KAZ

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Syphilitic hepatitis is a rare clinical presentation of syphilis and is easily misdiagnosed. However, clinical and histopathologic manifestations of Syphilitic Hepatitis can imitate other infectious and non-infectious diseases, and the diagnosis should be considered in patients with abnormal liver function tests. We present an unusual case of syphilitic hepatitis presenting with jaundice and abdominal bloating after treatment with benzylpenicillin, liver enzymes, and mucocutaneous findings improved.

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Syphilis Hepatitis Presenting as a Mimic of Primary Biliary Cholangitis

Cited by 5 publications

References 13 publications

The Great Mimicker Gets Caught: A Rare Case of Syphilis in the Gastrointestinal Tract

The Great Mimicker Gets Caught: A Rare Case of Syphilis in the Gastrointestinal Tract

When the Sailor’s Handshake Fails: A Case of Syphilitic Hepatitis in an HIV Patient With Nonspecific Liver Biopsy and Atypical Cutaneous Presentation

Сase report of syphilitic hepatitis

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