Department of General Medicine, International University of Health and Welfare Narita Hospital, Japan.
Department of Pathology, International University of Health and Welfare, Japan.
Intern Med. 2023 Apr 1;62(7):1095-1097. doi: 10.2169/internalmedicine.9779-22. Epub 2022 Aug 30.
A 77-year-old man arrived at our hospital with bilateral shoulder pain persisting for several months and headache for 1 month. Giant cell arteritis with polymyalgia rheumatica was suspected. However, considering his medical history of testing positive for syphilis, we submitted a sample for a syphilis serology test, which yielded positive results. The Treponema pallidum hemagglutination assay of cerebrospinal fluid was positive, and a temporal artery biopsy revealed vasculitis, confirming the diagnosis of tertiary syphilis. He was successfully treated for two weeks with penicillin G infusions. Symptoms reminiscent of giant cell arteritis and polymyalgia rheumatica may reveal syphilis, which is called the "great imitator."
一位 77 岁男性因双侧肩部疼痛持续数月和头痛 1 个月就诊于我院。考虑巨细胞动脉炎合并风湿性多肌痛，但鉴于其梅毒血清学阳性的病史，我们送检了一份梅毒血清学检查样本，结果为阳性。脑脊液梅毒螺旋体血凝试验阳性，颞动脉活检显示血管炎，确诊为三期梅毒。经 2 周青霉素 G 输注治疗后，患者症状缓解。类似巨细胞动脉炎和风湿性多肌痛的症状可能提示梅毒，故该病被称为“伟大的模仿者”。
