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Management of syphilitic hepatitis
Abdurrahman Kaya1, Sibel Yıldız Kaya2
1Department of Infectious Diseases, İstanbul Training and Research Hospital, Istanbul, Turkey. dr.abdkaya@hotmail.com.
BMC Gastroenterology
|November 13, 2020
Summary
Syphilitic hepatitis, a rare complication of syphilis, presents with elevated alkaline phosphatase and skin rashes, especially on palms and soles. It should be considered in patients with abnormal liver enzymes and these characteristic rashes.
Area of Science:
- Hepatology
- Infectious Diseases
- Dermatology
Background:
- Syphilis, a sexually transmitted infection caused by Treponema pallidum, rarely affects the liver.
- Liver involvement, known as syphilitic hepatitis, typically manifests during the secondary phase of the disease.
Purpose of the Study:
- To highlight the importance of considering syphilitic hepatitis in the differential diagnosis of abnormal liver function tests.
- To emphasize the diagnostic significance of skin manifestations in conjunction with liver enzyme abnormalities.
Main Methods:
- Review of clinical presentation and diagnostic features of syphilitic hepatitis.
- Analysis of laboratory findings, including serum alkaline phosphatase and transaminases.
- Correlation of dermatological findings with hepatic involvement.
Main Results:
- Syphilitic hepatitis is generally a mild condition.
- Characterized by elevated serum alkaline phosphatase levels, often with normal or minimally elevated transaminases.
- Diffuse, symmetric maculopapular rashes, particularly involving palms and soles, are key indicators.
Conclusions:
- Syphilitic hepatitis should be included in the differential diagnosis for patients presenting with abnormal liver enzymes, especially elevated alkaline phosphatase.
- The presence of rashes on palms and soles strongly suggests secondary syphilis, including hepatic involvement.
- Early consideration of syphilitic hepatitis can lead to timely diagnosis and treatment.
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