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Rare disease
Case report
Cholestatic hepatitis with concomitant nephrotic syndrome due to late syphilis in an immunocompetent 32-year-old man
  1. Philipp Kasper,
  2. Anna Martin,
  3. Dirk Nierhoff and
  4. Tobias Goeser
  1. Department of Gastroenterology and Hepatology, University of Cologne, Cologne, North Rhine Westphalia, Germany
  1. Correspondence to Dr Philipp Kasper; philipp.kasper{at}uk-koeln.de

Abstract

A 32-year-old man was referred to our clinic for evaluation of abnormal liver function tests and concurrent proteinuria. Physical examination revealed a maculopapular rash, involving the trunk and palms, and multiple ‘moth-eaten’ patches of alopecia. After a prolonged diagnostic work-up a hepatitis with concomitant nephrotic syndrome due to secondary syphilis was diagnosed. Treatment with benzylpenicillin led to complete clinical recovery. Syphilis is a re-emerging infectious disease with heterogeneous clinical presentation that should be considered in the differential diagnosis of inexplicable simultaneous liver and kidney dysfunction in patients with high-risk sexual behaviour.

Syphilis is a re-emerging infectious disease with heterogeneous clinical presentation that should be considered in the differential diagnosis of inexplicable simultaneous liver and kidney dysfunction in patients with high-risk sexual behaviour.

  • renal system
  • gastroenterology
  • infection (gastroenterology)
  • hepatitis other

https://doi.org/10.1136/bcr-2019-232615

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    Footnotes

    • Contributors AM and PK involved in the conception and design of the case report and performed acquisition of data. AM, PK, DN and TG involved in the analysis and interpretation of clinical results. AM and PK performed drafting of the manuscript. DN and TG involved in critical revision of the manuscript for important intellectual content. AM and PK contributed equally to this work.

    • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

    • Competing interests None declared.

    • Patient consent for publication Obtained.

    • Provenance and peer review Not commissioned; externally peer reviewed.