Veeravahu M
Arch Intern Med. 1985 Jan;145(1):132-4.
The diagnosis of liver involvement in early syphilis has always posed problems because of its rarity and the difficulty of excluding coincidental liver disease caused by a multitude of pathogens. Case reports deal predominantly with jaundiced homosexual men in whom syphilis is discovered later, and the prospective studies of patients with early syphilis disclose only mild biochemical abnormalities in liver function test results. There is no single characteristic feature attributable to early syphilitic hepatitis. Even liver histologic findings are variable. At least in those patients who have jaundice, there is a likelihood of coincidental viral hepatitis. Therefore, the evidence to implicate Treponema pallidum as a liver pathogen in early syphilis is not convincing.
早期梅毒肝脏受累的诊断一直存在问题，因为其罕见性以及难以排除由多种病原体引起的巧合性肝病。病例报告主要涉及后来才发现梅毒的黄疸同性恋男性，而对早期梅毒患者的前瞻性研究仅揭示肝功能测试结果中存在轻度生化异常。早期梅毒肝炎没有单一的特征性表现。即使肝脏组织学发现也是多变的。至少在那些出现黄疸的患者中，存在巧合性病毒性肝炎的可能性。因此，将梅毒螺旋体认定为早期梅毒肝脏病原体的证据并不确凿。
