Cholestatic Liver Injury in a Patient with Tertiary Syphilis

Sahaj Mujumdar; Jason Goldenberg; Steven Bieser; Alice S Pang; Robert Coben

doi:10.1159/000526247

Cholestatic Liver Injury in a Patient with Tertiary Syphilis

Case Rep Gastroenterol. 2022 Sep 19;16(3):552-556. doi: 10.1159/000526247. eCollection 2022 Sep-Dec.

Authors

Sahaj Mujumdar¹, Jason Goldenberg¹, Steven Bieser², Alice S Pang³, Robert Coben³

Affiliations

¹ aDepartment of Internal Medicine Thomas Jefferson University Hospital, Philadelphia, Pennsylvania, USA.
² bSidney Kimmel Medical College, Thomas Jefferson University Hospital, Philadelphia, Pennsylvania, USA.
³ cDivision of Gastroenterology and Hepatology, Department of Medicine, Thomas Jefferson University Hospital, Philadelphia, Pennsylvania, USA.

Abstract

Syphilis is a common infection that has variable presentations. We report a rare case of a 64-year-old male with 3 weeks of abdominal pain, back pain, and neurologic deficits including memory impairment who was found to have neurosyphilis causing a cholestatic liver injury. Workup included a positive rapid plasma reagin (RPR) and enzyme immunoassay (EIA), a positive cerebrospinal fluid (CSF) venereal disease research laboratory (VDRL), and a liver biopsy, which was compatible with a diagnosis of syphilitic hepatitis. Completion of a 14-day course of penicillin and 1 month of physical therapy resulted in near full-functional and biochemical recovery.

Keywords: Cholestatic; Hepatitis; Neurosyphilis; Syphilis; Transaminitis.

Publication types

Case Reports

Grants and funding

If accepted, this case report is made possible in part by support from the Thomas Jefferson University Open Access Fund. The funders had no role in case report design, collection and analysis, decision to publish, or preparation of the manuscript.