<?xml version="1.0" encoding="ISO-8859-1"?><article xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance">
<front>
<journal-meta>
<journal-id>2341-4545</journal-id>
<journal-title><![CDATA[GE-Portuguese Journal of Gastroenterology]]></journal-title>
<abbrev-journal-title><![CDATA[GE Port J Gastroenterol]]></abbrev-journal-title>
<issn>2341-4545</issn>
<publisher>
<publisher-name><![CDATA[Sociedade Portuguesa de Gastrenterologia]]></publisher-name>
</publisher>
</journal-meta>
<article-meta>
<article-id>S2341-45452022000400058</article-id>
<article-id pub-id-type="doi">10.1159/000516944</article-id>
<title-group>
<article-title xml:lang="en"><![CDATA[Exploring the Ways of &#8220;The Great Imitator&#8221;: A Case Report of Syphilitic Hepatitis]]></article-title>
<article-title xml:lang="pt"><![CDATA[Explorando as manifestações do &#8220;Grande Imitador&#8221;: um caso clínico de hepatite sifilítica]]></article-title>
</title-group>
<contrib-group>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Neves]]></surname>
<given-names><![CDATA[João A. Cunha]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Roseira]]></surname>
<given-names><![CDATA[Joana]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Sousa]]></surname>
<given-names><![CDATA[Helena Tavares de]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
<xref ref-type="aff" rid="Aaf"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Machado]]></surname>
<given-names><![CDATA[Rui]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
</contrib-group>
<aff id="Af1">
<institution><![CDATA[,Centro Hospitalar Universitário do Algarve Department of Gastroenterology ]]></institution>
<addr-line><![CDATA[Portimão ]]></addr-line>
<country>Portugal</country>
</aff>
<aff id="Af2">
<institution><![CDATA[,University of Algarve Department of Biomedical Sciences and Medicine ]]></institution>
<addr-line><![CDATA[Faro ]]></addr-line>
<country>Portugal</country>
</aff>
<aff id="Af3">
<institution><![CDATA[,Centro Hospitalar Universitário do Algarve Department of Infectious Diseases ]]></institution>
<addr-line><![CDATA[Portimão ]]></addr-line>
<country>Portugal</country>
</aff>
<pub-date pub-type="pub">
<day>30</day>
<month>08</month>
<year>2022</year>
</pub-date>
<pub-date pub-type="epub">
<day>30</day>
<month>08</month>
<year>2022</year>
</pub-date>
<volume>29</volume>
<numero>4</numero>
<fpage>58</fpage>
<lpage>61</lpage>
<copyright-statement/>
<copyright-year/>
<self-uri xlink:href="http://scielo.pt/scielo.php?script=sci_arttext&amp;pid=S2341-45452022000400058&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://scielo.pt/scielo.php?script=sci_abstract&amp;pid=S2341-45452022000400058&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://scielo.pt/scielo.php?script=sci_pdf&amp;pid=S2341-45452022000400058&amp;lng=en&amp;nrm=iso"></self-uri><abstract abstract-type="short" xml:lang="en"><p><![CDATA[Abstract  Introduction:  Syphilis is a chronic infection caused by Treponema pallidum. Manifestations of this disease are vast, and syphilitic hepatitis is a rarely depicted form of secondary syphilis.  Case Presentation:  We report the case of a 63-year-old man with worsening jaundice, maculopapular rash and perianal discomfort. Proctological examination with anoscopy revealed a perianal gray/white area with millimetric pale granules along the anal canal. Liver function tests showed a mixed pattern. Venereal Disease Research Laboratory, T. pallidum hemagglutination assay and IgM fluorescent treponemal antibody absorbance were positive. The patient was successfully treated with a single dose of penicillin G.  Discussion/Conclusion:  Syphilitic hepatitis is scarcely reported in the literature. Secondary syphilis with mild hepatitis rarely leads to hepatic cytolysis and jaundice. Many signs of secondary syphilis including syphilitic hepatitis may be linked to immune responses initiated during early infection. Over the past decades, evidence has emerged on the importance of innate and adaptive cellular immune responses in the immunopathogenesis of syphilis. This report raises awareness to a clinical entity that should be considered in patients at risk for sexually transmitted diseases, who present with intestinal discomfort or liver dysfunction, as it is a treatable and fully reversible condition.]]></p></abstract>
<abstract abstract-type="short" xml:lang="pt"><p><![CDATA[Resumo  Introdução:  A sífilis é uma infeção crónica provocada pelo Treponema pallidum. As manifestações desta doença são vastas e a hepatite sifilítica é uma forma de sífilis secundária raramente descrita.  Caso Clínico:  Apresentamos o caso de um doente de 63 anos com icterícia de agravamento progressivo, rash maculopapular e desconforto perianal. O exame proctológico complementado por anuscopia revelou uma região perianal cinzenta-esbranquiçada com grânulos pálidos milimétricos ao longo do canal anal. Testes de função hepática revelaram um padrão misto e o Venereal Disease Research Laboratory, T. pallidum hemagglutination assay e IgM fluorescent treponemal antibody absorbance foram positivos. O doente foi tratado com sucesso com uma dose única de penicilina G.  Discussão/Conclusão:  São raros os casos de hepatite sifilítica descritos na literatura. Sífilis secundária com hepatite ligeira raramente conduz a citólise hepática e icterícia. Muitos dos sinais de sífilis secundária, incluindo a hepatite sifilítica, parecem estar associados a respostas imunitárias iniciadas durante o período de infeção precoce. Ao longo das últimas décadas, têm surgido evidências crescentes sobre a importância das respostas imunes inata e adaptativa na patogénese da sífilis. Este caso clínico descreve uma entidade nosológica que deve ser considerada em doentes em risco de contraírem doenças sexualmente transmissíveis, que se apresentem com desconforto intestinal ou disfunção hepática, visto tratar-se de uma condição tratável e totalmente reversível.]]></p></abstract>
<kwd-group>
<kwd lng="en"><![CDATA[Syphilis]]></kwd>
<kwd lng="en"><![CDATA[Treponema pallidum]]></kwd>
<kwd lng="en"><![CDATA[Syphilitic hepatitis]]></kwd>
<kwd lng="en"><![CDATA[Secondary syphilis]]></kwd>
<kwd lng="en"><![CDATA[Case report]]></kwd>
<kwd lng="pt"><![CDATA[Sífilis]]></kwd>
<kwd lng="pt"><![CDATA[Treponema pallidum]]></kwd>
<kwd lng="pt"><![CDATA[Hepatite sifilítica]]></kwd>
<kwd lng="pt"><![CDATA[Sífilis secundária]]></kwd>
<kwd lng="pt"><![CDATA[Caso clínico]]></kwd>
</kwd-group>
</article-meta>
</front><back>
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