Korean J Nephrol.
2004 Jan;23(1):152-157.
Nephrotic Syndrome, Hepatitis and Gastric Involvement in Secondary Syphilis
- Affiliations
-
- 1Department of Internal Medicine, School of Medicine, Catholic University of Daegu, Korea. ihlee@cu.ac.kr
- 2Department of Pathology, School of Medicine, Catholic University of Daegu, Korea.
- 3Department of Pathology, School of Medicine, Yeungnam University, Daegu, Korea.
Abstract
- Syphilis, caused by the spirochete Treponema pallidum, is a chronic systemic infectious disease. Nephrotic syndrome, hepatitis, or gastric involvement resulting from secondary syphilis are well-documented complications, but very rare. Moreover, the simultaneous occurrence of these complications in the same patient is extremely rare. This report describes 43-year-old male patient with syphilis presented with features of nephrotic syndrome, acute hepatitis, and gastric involvement. A diagnosis of secondary syphilis was made by skin lesions and serologic tests for syphilis. After a diagnosis of syphilis, we supposed that nephrotic syndrome and hepatitis were the complications of secondary syphilis and performed kidney and liver biopsies. A kidney biopsy revealed membranous nephropathy characterized by subepithelial hump-like electron-dense deposits and effacement of epithelial foot-processes on electron microscopy. A liver biopsy showed a feature of lobular hepatitis with a few granulomas. Esophagogastroduodenoscopy (EGD) showed multiple shallow ulcers with varying degrees of nodular mucosa at gastric antrum. The patient was treated with intramuscular benzathine penicillin G, 2.4 million units. Proteinuria, skin lesion, hepatitis, and EGD finding were resolved rapidly after penicillin therapy. In conclusion, syphilis should be considered in the differential diagnosis of the nephrotic syndrome, hepatitis, and gastric involvement occurring separately or simultaneously.
MeSH Terms
-
Adult
Biopsy
Communicable Diseases
Diagnosis
Diagnosis, Differential
Endoscopy, Digestive System
Glomerulonephritis, Membranous
Granuloma
Hepatitis*
Humans
Kidney
Liver
Male
Microscopy, Electron
Mucous Membrane
Nephrotic Syndrome*
Penicillin G Benzathine
Penicillins
Proteinuria
Pyloric Antrum
Serologic Tests
Skin
Spirochaetales
Syphilis*
Treponema pallidum
Ulcer
Penicillin G Benzathine
Penicillins
