Archambeaud-Mouveroux F, Morand P, Bernard P, Sautereau D, Meloni B, Antoine E, Catanzano G
Gastroenterol Clin Biol. 1987 Jan;11(1):93-5.
A case of secondary syphilitic hepatitis is reported. A 49-year old woman was admitted for weight-loss, fever, hepatomegaly and splenomegaly. Diagnosis of syphilitic hepatitis was based on cholestasis associated with positive serologic tests for syphilis without other immunological disturbances. Biopsy of the liver showed a moderate infiltration in and around the portal tracts. Immunofluorescence study for treponema was negative. Rapid improvement was obtained with penicillin initially associated with steroid therapy. Liver involvement in secondary syphilis is characterized by anicteric cholestasis, an inflammatory syndrome, and periportal infiltrate inconstantly associated with centrilobular necrosis, granulomatous reaction and presence of treponemas in the lesions. Due to the increasing frequency of sexually transmitted diseases, this diagnosis could become more frequent.
报告了一例二期梅毒肝炎病例。一名49岁女性因体重减轻、发热、肝肿大和脾肿大入院。梅毒肝炎的诊断基于胆汁淤积，梅毒血清学检测呈阳性且无其他免疫紊乱。肝脏活检显示门管区及其周围有中度浸润。梅毒螺旋体免疫荧光研究为阴性。最初使用青霉素联合类固醇治疗后迅速改善。二期梅毒的肝脏受累表现为无黄疸性胆汁淤积、炎症综合征以及门周浸润，常伴有小叶中心坏死、肉芽肿反应和病变部位存在梅毒螺旋体。由于性传播疾病的发病率不断上升，这种诊断可能会更加常见。
