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Nephrotic syndrome and hepatitis in early syphilis
A L Tang1, R N Thin, D N Croft
1Department of Genitourinary Medicine, St Thomas' Hospital, London, UK.
Postgraduate Medical Journal
|January 1, 1989
Summary
Syphilis can cause acute hepatitis and nephrotic syndrome. This diagnosis was unexpected, highlighting the need to consider syphilis in patients with these conditions.
Area of Science:
- Nephrology
- Hepatology
- Infectious Diseases
Background:
- The nephrotic syndrome is a kidney disorder characterized by heavy proteinuria, hypoalbuminemia, edema, and hyperlipidemia.
- Acute hepatitis refers to liver inflammation developing over less than six months, often presenting with jaundice, fatigue, and abdominal pain.
Observation:
- A 54-year-old male patient presented with symptoms indicative of both acute hepatitis and nephrotic syndrome.
- The underlying cause of these concurrent conditions was not immediately apparent, necessitating comprehensive diagnostic evaluations.
Findings:
- Extensive investigations ultimately led to the incidental diagnosis of active syphilis.
- This case underscores the potential for syphilis to manifest with hepatic and renal involvement.
Implications:
- Syphilis should be included in the differential diagnosis for patients presenting with acute hepatitis.
- The possibility of syphilis must be considered in cases of nephrotic syndrome, particularly when co-occurring with liver dysfunction.
- Clinicians should maintain a high index of suspicion for syphilis in unexplained cases of hepatitis and nephrotic syndrome.
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