Diagnostic Challenges in Concurrent Primary Biliary Cholangitis and Secondary Syphilis: A Case Report

Area of Science:

• Hepatology
• Infectious Diseases
• Autoimmune Disorders

Background:

• Primary biliary cholangitis (PBC) is a chronic autoimmune liver disease.
• Secondary syphilis is an infectious disease caused by *Treponema pallidum*.
• Coexistence of PBC and syphilis is rare, posing diagnostic challenges.

Observation:

• A patient presented with symptoms suggestive of cholestatic liver disease.
• The patient was diagnosed with both PBC and secondary syphilis during hospitalization.
• Clinical presentation and laboratory findings required careful evaluation to distinguish between the two conditions.

Findings:

• The case highlights the diagnostic difficulty in differentiating syphilitic hepatitis from autoimmune liver disease, specifically PBC.
• A comprehensive workup was essential for accurate diagnosis.
• This underscores the potential for overlapping clinical and biochemical features between infectious and autoimmune etiologies of liver disease.

Implications:

• Clinicians must consider a broad differential diagnosis for cholestatic liver disease, including infectious causes.
• Thorough patient history and extensive investigations are crucial for managing complex cases.
• This case emphasizes the importance of recognizing the potential for concurrent, unrelated conditions impacting liver function.