Work

Syphilitic Cholangiopathy Mimicking Primary Sclerosing Cholangitis

Year: 2025

Type: article

Abstract: INTRODUCTION: Syphilis is a sexually transmitted disease with variable symptoms, often imitating various other disorders. Syphilis progresses through primary, secondary, latent, and tertiary stages, each with distinct clinical manifestations. A sudden rise in serum hepatic enzyme levels and imaging findings that mimic sclerosing cholangitis, both associated with a positive response to targeted antibiotic treatment, may indicate a diagnosis of acute syphilitic hepatitis. CASE PRESENTATION: We report a case of early syphilis in the secondary stage, manifesting as sclerosing-cholangitis-like changes shown on ultrasonography, MR, and CT. Narrow-spectrum antibiotic therapy with procaine benzylpenicillin led to a consistent decrease in and normalization of levels of serum bilirubin and other markers of hepatic injury. Repeated sonography and MR cholangiography showed minimal residual changes in the intrahepatic biliary tree. CONCLUSIONS: is one of the rare causes of secondary cholangitis. As the incidence of syphilis is rising worldwide, it should be considered as a differential diagnosis, especially for patients with high-risk sexual behavior and for whom there are laboratory findings of cholestatic or mixed cytolytic and cholestatic hepatitis, particularly if associated with exanthema, pharyngitis, and lymphadenopathy.

Source: Infectious Disease Reports

DOI: 10.3390/idr17020023

Authors: Adriana Gregušová, Michal Gergel, Miroslav Žigrai

Institutions: Slovak Medical University, University Hospital Bratislava

Language: English

Topic: Syphilis Diagnosis and Treatment

Subfield: Physiology

Field: Medicine

Domain: Health Sciences

SDG: Good health and well-being

Open Access status: gold

Estimated APC paid: $2,172