Clin Endosc.  2015 May;48(3):256-259. 10.5946/ce.2015.48.3.256.

Gastric Syphilis and Membranous Glomerulonephritis

• Roh M
• Sohn JH
• Kim TY
• Kim SJ
• Kim JS
• Chung SJ
• Pyo JY
• Oh YH

• KMID: 2148576
• DOI: http://doi.org/10.5946/ce.2015.48.3.256

Abstract

Syphilis is a chronic systemic infectious disease caused by the bacterium Treponema pallidum. Gastric involvement and nephrotic syndrome are uncommon but well documented complications of syphilis, but the co-occurrence of these two complications in the same patient is extremely rare. Thus, because of their nonspecific presentation, suspicion of gastric syphilis (GS) and nephrotic syndrome is essential for diagnosis. Patients should be investigated thoroughly and a diagnosis made based on clinical, endoscopic, and histological findings, in order to initiate appropriate therapy. We report of a 34-year-old male patient with a history of epigastric pain and a diagnosis of GS and syphilis-associated membranous glomerulonephritis confirmed by gastroscopy and kidney biopsy, who was treated successfully with penicillin G benzathine. This case report provides information on the typical features of GS that should help raise awareness of this rare disease entity among clinicians, resulting in earlier diagnosis and administration of appropriate therapy.

Keyword

Glomerulonephritis, membranous; Stomach; Syphilis

MeSH Terms

Adult
Biopsy
Communicable Diseases
Diagnosis
Gastroscopy
Glomerulonephritis, Membranous*
Humans
Kidney
Male
Nephrotic Syndrome
Penicillin G Benzathine
Rare Diseases
Stomach
Syphilis*
Treponema pallidum
Penicillin G Benzathine

Figure

• 

  Fig. 1 Gastroscopic findings. Multiple irregular, shallow ulcers covered with whitish exudates and central depression in the (A) antrum, (B) body, and (C) cardia.

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  Fig. 2 Histologic findings of gastric biopsy. (A) Marked severe inflammation with lymphoplasmacytic infiltrates (H&E stain, ×400). (B) Numerous spirochetes are present between foveolar epithelial cells (Warthin-Starry stain, ×1,000).

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  Fig. 3 Histologic findings of kidney biopsy. (A) Light microscopy showing slight thickening of the glomerular capillary walls (Periodic acid-Schiff stain, ×400). (B) Immunofluorescence showing weak granular staining for immunoglobulin G along the capillary walls (×400).

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