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Cholestatic hepatitis and thrombocytosis in a secondary syphilis patient.

Kim GH, Kim BU, Lee JH, Choi YH, Chae HB, Park SM, Youn SJ, Lee JY, Yoon TY, Sung R - J. Korean Med. Sci. (2010)

Bottom Line: The 42-yr-old male complained of flu-like symptoms and skin eruptions on his palms and soles.He recovered from his symptoms and elevated liver related enzymes with treatment.Because syphilitic hepatitis can present without any typical signs of accompanying syphilis, syphilis should be considered as a possible cause in acute hepatitis patients.

View Article: PubMed Central - PubMed

Affiliation: Department of Internal Medicine, Chungbuk National University, College of Medicine and Medical Research Institute, Cheongju, Korea.

ABSTRACT
The incidence of acute hepatitis in syphilis patient is rare. First of all, our patient presented with hepatitis comorbid with thrombocytosis. To our knowledge, this is only the second report of syphilitic hepatitis with thrombocytosis. The 42-yr-old male complained of flu-like symptoms and skin eruptions on his palms and soles. Laboratory findings suggested an acute hepatitis and thrombocytosis. Serologic test results were positive for VDRL. He recovered from his symptoms and elevated liver related enzymes with treatment. Because syphilitic hepatitis can present without any typical signs of accompanying syphilis, syphilis should be considered as a possible cause in acute hepatitis patients.

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Clinical course after the treatment. The serum level of total bilirubin and alkaline phosphatase has significantly declined after the benzathine penicillin treatment. ALP, alkaline phosphatase.
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Figure 4: Clinical course after the treatment. The serum level of total bilirubin and alkaline phosphatase has significantly declined after the benzathine penicillin treatment. ALP, alkaline phosphatase.

Mentions: The patient was treated with weekly intramuscular benzathine penicillin, 2,400,000 U, for a total of three doses. One week after treatment, his fatigue and rash were markedly improved. Three weeks after treatment, ALP was 288 IU/L, total bilirubin was 0.3 mg/dL (Fig. 4) and four weeks after treatment, the VDRL titer was down to 1:64. He did not develop a Jarisch-Herxheimer reaction. Positive serologic tests and a prompt response to penicillin treatment confirmed the diagnosis of syphilitic cholestatic hepatitis.


Cholestatic hepatitis and thrombocytosis in a secondary syphilis patient.

Kim GH, Kim BU, Lee JH, Choi YH, Chae HB, Park SM, Youn SJ, Lee JY, Yoon TY, Sung R - J. Korean Med. Sci. (2010)

Clinical course after the treatment. The serum level of total bilirubin and alkaline phosphatase has significantly declined after the benzathine penicillin treatment. ALP, alkaline phosphatase.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC2967006&req=5

Figure 4: Clinical course after the treatment. The serum level of total bilirubin and alkaline phosphatase has significantly declined after the benzathine penicillin treatment. ALP, alkaline phosphatase.
Mentions: The patient was treated with weekly intramuscular benzathine penicillin, 2,400,000 U, for a total of three doses. One week after treatment, his fatigue and rash were markedly improved. Three weeks after treatment, ALP was 288 IU/L, total bilirubin was 0.3 mg/dL (Fig. 4) and four weeks after treatment, the VDRL titer was down to 1:64. He did not develop a Jarisch-Herxheimer reaction. Positive serologic tests and a prompt response to penicillin treatment confirmed the diagnosis of syphilitic cholestatic hepatitis.

Bottom Line: The 42-yr-old male complained of flu-like symptoms and skin eruptions on his palms and soles.He recovered from his symptoms and elevated liver related enzymes with treatment.Because syphilitic hepatitis can present without any typical signs of accompanying syphilis, syphilis should be considered as a possible cause in acute hepatitis patients.

View Article: PubMed Central - PubMed

Affiliation: Department of Internal Medicine, Chungbuk National University, College of Medicine and Medical Research Institute, Cheongju, Korea.

ABSTRACT
The incidence of acute hepatitis in syphilis patient is rare. First of all, our patient presented with hepatitis comorbid with thrombocytosis. To our knowledge, this is only the second report of syphilitic hepatitis with thrombocytosis. The 42-yr-old male complained of flu-like symptoms and skin eruptions on his palms and soles. Laboratory findings suggested an acute hepatitis and thrombocytosis. Serologic test results were positive for VDRL. He recovered from his symptoms and elevated liver related enzymes with treatment. Because syphilitic hepatitis can present without any typical signs of accompanying syphilis, syphilis should be considered as a possible cause in acute hepatitis patients.

Show MeSH
Related in: MedlinePlus