[Syphilitic hepatitis. Report of three cases]

Area of Science:

• Hepatology
• Infectious Diseases
• Syphilology

Background:

• Syphilis, a sexually transmitted infection caused by *Treponema pallidum*, can manifest with diverse clinical presentations.
• Hepatic involvement in syphilis is rare, occurring in approximately 0.2% to 3% of infected individuals.
• Early diagnosis and treatment are crucial for managing syphilis and preventing long-term complications.

Observation:

• Three male patients presented with symptoms suggestive of liver involvement, including malaise, erythema, arthralgias, and itching.
• Laboratory investigations revealed elevated liver enzymes, specifically gamma-glutamyl transpeptidase (GGT) and alkaline phosphatases.
• All three patients had positive results on the Venereal Disease Research Laboratory (VDRL) test, confirming active syphilis.

Findings:

• Penicillin therapy was administered to all patients.
• Following treatment, patients experienced resolution of their presenting symptoms, including skin manifestations and malaise.
• Liver enzyme levels (GGT and alkaline phosphatases) normalized in all cases, indicating successful management of hepatic syphilis.

Implications:

• This case series highlights that syphilis should be considered in the differential diagnosis of unexplained liver enzyme abnormalities.
• Prompt diagnosis and appropriate penicillin treatment are effective in resolving hepatic manifestations of syphilis.
• Further research may elucidate the precise mechanisms of liver injury in syphilis and optimize treatment strategies.