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[Hepatic involvement in secondary syphilis].

F Archambeaud-Mouveroux, P Morand, P Bernard

    Gastroenterologie Clinique Et Biologique
    |January 1, 1987
    PubMed
    Summary
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    Secondary syphilitic hepatitis, a rare liver manifestation of syphilis, can present with jaundice-free cholestasis and inflammation. Early diagnosis and penicillin treatment lead to rapid recovery.

    Area of Science:

    • Hepatology
    • Infectious Diseases
    • Syphilology

    Background:

    • Secondary syphilis, a systemic stage of Treponema pallidum infection, can manifest with diverse clinical presentations.
    • Liver involvement, though uncommon, is a recognized but often overlooked complication of secondary syphilis.

    Observation:

    • A 49-year-old woman presented with weight loss, fever, hepatomegaly, and splenomegaly.
    • Cholestasis with positive syphilis serology, in the absence of other immunological disorders, led to the diagnosis.
    • Liver biopsy revealed portal tract inflammation; immunofluorescence for treponema was negative.

    Findings:

    • The patient's syphilitic hepatitis resolved rapidly with penicillin and steroid therapy.
    • Histopathological findings included periportal infiltration, consistent with syphilitic liver disease.

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  • The case highlights the diagnostic challenge of syphilitic hepatitis, often mimicking other liver conditions.

    • Implications:

    • Increased prevalence of sexually transmitted diseases may lead to a rise in syphilitic hepatitis cases.
    • Clinicians should consider secondary syphilis in the differential diagnosis of unexplained cholestasis and hepatitis.
    • Prompt diagnosis and treatment are crucial for favorable outcomes in syphilitic hepatitis.