Exploring the Ways of “The Great Imitator”: A Case Report of Syphilitic Hepatitis
Autor(a) principal: | |
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Data de Publicação: | 2022 |
Outros Autores: | , , |
Tipo de documento: | Relatório |
Idioma: | eng |
Título da fonte: | Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) |
Texto Completo: | http://scielo.pt/scielo.php?script=sci_arttext&pid=S2341-45452022000400058 |
Resumo: | 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. |
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Exploring the Ways of “The Great Imitator”: A Case Report of Syphilitic HepatitisSyphilisTreponema pallidumSyphilitic hepatitisSecondary syphilisCase reportAbstract 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.Sociedade Portuguesa de Gastrenterologia2022-08-01info:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/reporttext/htmlhttp://scielo.pt/scielo.php?script=sci_arttext&pid=S2341-45452022000400058GE-Portuguese Journal of Gastroenterology v.29 n.4 2022reponame:Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)instname:Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informaçãoinstacron:RCAAPenghttp://scielo.pt/scielo.php?script=sci_arttext&pid=S2341-45452022000400058Neves,João A. CunhaRoseira,JoanaSousa,Helena Tavares deMachado,Ruiinfo:eu-repo/semantics/openAccess2024-02-06T17:34:20Zoai:scielo:S2341-45452022000400058Portal AgregadorONGhttps://www.rcaap.pt/oai/openaireopendoar:71602024-03-20T02:36:18.720956Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) - Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informaçãofalse |
dc.title.none.fl_str_mv |
Exploring the Ways of “The Great Imitator”: A Case Report of Syphilitic Hepatitis |
title |
Exploring the Ways of “The Great Imitator”: A Case Report of Syphilitic Hepatitis |
spellingShingle |
Exploring the Ways of “The Great Imitator”: A Case Report of Syphilitic Hepatitis Neves,João A. Cunha Syphilis Treponema pallidum Syphilitic hepatitis Secondary syphilis Case report |
title_short |
Exploring the Ways of “The Great Imitator”: A Case Report of Syphilitic Hepatitis |
title_full |
Exploring the Ways of “The Great Imitator”: A Case Report of Syphilitic Hepatitis |
title_fullStr |
Exploring the Ways of “The Great Imitator”: A Case Report of Syphilitic Hepatitis |
title_full_unstemmed |
Exploring the Ways of “The Great Imitator”: A Case Report of Syphilitic Hepatitis |
title_sort |
Exploring the Ways of “The Great Imitator”: A Case Report of Syphilitic Hepatitis |
author |
Neves,João A. Cunha |
author_facet |
Neves,João A. Cunha Roseira,Joana Sousa,Helena Tavares de Machado,Rui |
author_role |
author |
author2 |
Roseira,Joana Sousa,Helena Tavares de Machado,Rui |
author2_role |
author author author |
dc.contributor.author.fl_str_mv |
Neves,João A. Cunha Roseira,Joana Sousa,Helena Tavares de Machado,Rui |
dc.subject.por.fl_str_mv |
Syphilis Treponema pallidum Syphilitic hepatitis Secondary syphilis Case report |
topic |
Syphilis Treponema pallidum Syphilitic hepatitis Secondary syphilis Case report |
description |
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. |
publishDate |
2022 |
dc.date.none.fl_str_mv |
2022-08-01 |
dc.type.status.fl_str_mv |
info:eu-repo/semantics/publishedVersion |
dc.type.driver.fl_str_mv |
info:eu-repo/semantics/report |
format |
report |
status_str |
publishedVersion |
dc.identifier.uri.fl_str_mv |
http://scielo.pt/scielo.php?script=sci_arttext&pid=S2341-45452022000400058 |
url |
http://scielo.pt/scielo.php?script=sci_arttext&pid=S2341-45452022000400058 |
dc.language.iso.fl_str_mv |
eng |
language |
eng |
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http://scielo.pt/scielo.php?script=sci_arttext&pid=S2341-45452022000400058 |
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info:eu-repo/semantics/openAccess |
eu_rights_str_mv |
openAccess |
dc.format.none.fl_str_mv |
text/html |
dc.publisher.none.fl_str_mv |
Sociedade Portuguesa de Gastrenterologia |
publisher.none.fl_str_mv |
Sociedade Portuguesa de Gastrenterologia |
dc.source.none.fl_str_mv |
GE-Portuguese Journal of Gastroenterology v.29 n.4 2022 reponame:Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) instname:Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informação instacron:RCAAP |
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Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informação |
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RCAAP |
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RCAAP |
reponame_str |
Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) |
collection |
Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) |
repository.name.fl_str_mv |
Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) - Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informação |
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