Syphilitic hepatitis: a case report and review of the literature

Syphilis is a common disease that has been researched and focused on for many years, however, syphilitic hepatitis has not been well-recognized. We report this case of syphilitic hepatitis with intrahepatic cholestasis and liver granulomas to make a deeper impression. A 47-year-old male was admitted...

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Bibliographic Details
Published in:BMC gastroenterology 2019-11, Vol.19 (1), p.191-191, Article 191
Main Authors: Huang, Jiaofeng, Lin, Su, Wang, Mingfang, Wan, Bo, Zhu, Yueyong
Format: Article
Language:English
Subjects:
Anti-Bacterial Agents - therapeutic use
Antibodies
Antigens
Case Report
Cholestasis
Cholestasis, Intrahepatic - pathology
Criminal investigation
Diagnostic imaging
DNA
Enzymes
Genetic research
Granuloma - pathology
Health aspects
Hepatitis
Hepatitis - diagnosis
Hepatitis - drug therapy
Hepatitis - microbiology
Hepatitis - pathology
Hepatitis B
Hepatitis C virus
HIV
HIV antibodies
Humans
Infection
Jaundice
Liver
Liver - enzymology
Liver - pathology
Male
Medical research
Middle Aged
Necrosis
Penicillin G Benzathine - therapeutic use
Penicillins
Rash
Rashes
Syphilis
Syphilis - diagnosis
Syphilis - drug therapy
Syphilis - pathology
Treponema pallidum - isolation & purification
Ultrasound imaging
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Summary:Syphilis is a common disease that has been researched and focused on for many years, however, syphilitic hepatitis has not been well-recognized. We report this case of syphilitic hepatitis with intrahepatic cholestasis and liver granulomas to make a deeper impression. A 47-year-old male was admitted with jaundice and rashes. The laboratory examination showed abnormal liver enzymes with significant increases in ALP and GGT but mild increases in ALT and AST. His HBV surface antigen was weakly positive, with negative HIV antibody, HCV antibody, and undetectable HBV DNA. The rapid plasma reagin test and the Treponema pallidum particle assay tests for Syphilis were both positive. Abdominal ultrasonography and magnetic resonance cholangiopancreatography revealed the normal biliary tract, liver, and spleen. The liver pathological examination showed cholangiocyte inflammation and micro-granulomas with coagulation necrosis. After 2 months of benzathine penicillin treatment, his liver enzyme decreased rapidly and remained normal after 1-year of follow-up. Increased liver enzymes, intrahepatic cholestasis and liver granulomas with well-response to antibiotics may provide clues for the diagnosis of syphilitic hepatitis.
ISSN:1471-230X
1471-230X
DOI:10.1186/s12876-019-1112-z