Abstract

MARADO, Daniela et al. Syphilis: a rare cause of cholestatic hepatitis. J Port Gastrenterol. [online]. 2013, vol.20, n.2, pp.70-73. ISSN 0872-8178.  https://doi.org/10.1016/j.jpg.2012.04.034.

Background: Although changes in liver function tests may occur with some frequency in syphilis, a clinical hepatitis with jaundice is a rare situation. Clinical case: Male, 35 years old, who appealed to the Emergency Room (ER) with mucocutaneous jaundice, dark urine and fecal acholia with one week of evolution. He described the appearance of skin lesions 3 weeks before, involving the palms and soles, as well as abdominal pain, weight loss, night sweats and multiple lymph nodes enlargements. From the complementary study performed, we can highlight a hyperbilirubinaemia, increased activity of the sérum enzymes alkaline phosphatase, gama-glutammyltransferase and aminotransferases levels and still negative serology for HIV, HBV and HCV. The imagiological study excluded biliary tract obstruction. Syphilis screening (VDRL/RPR) was positive, with titers of 1:32 and the ELISA assay confirmed active infection. The patient was treated with benzathine penicillin. Discussion/Conclusion: The pathogenic mechanism of syphilitic hepatitis is not currently known, but this disorder appears associated with secondary syphilis. It is extremely rare, but, nevertheless, it should be considered in the differential diagnosis of cholestatic hepatitis.

Keywords : Hepatitis; Syphilis; Cholestasis.

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