Syphilis can virtually affect any organ of the human body. Syphilitic hepatitis, also called 'luetic jaundice', is a rare manifestation of syphilis signifying spirochete dissemination to the liver. It was first recognized in 1585[1] and was initially reported in the literature by Harn in 1943[2]. The actual incidence of syphilitic hepatitis is uncertain. However, it occurs in 0.2 to 38% of patients with a history of syphilis diagnosis[3][4].
Syphilitic hepatitis is usually defined as a cholestatic pattern of liver enzyme elevation with serological treponemal evidence in the absence of other causes of hepatic dysfunction, and improvement after appropriate antimicrobial therapy[5].
Involvement of the liver can occur at any stage of the disease, although most cases have been reported to occur during the early stages of syphilis[6].
Due to the recent increase in the incidence of primary and secondary syphilis, it is imperative that clinicians should consider syphilis in the differential diagnosis of patients with liver dysfunction and elevated liver function tests (LFTs) of unclear etiology[5].
[1] Tolia et al: The great impostor: transaminitis masking the coinfection of syphilis and human immunodeficiency virus in Case Report - 2017. See here.
[2] Subedi et al: Syphilitic hepatitis as a manifestation of secondary syphilis in Baylor University Medical Center Proceedings - 2021.
[3] Mezzano et al: Syphilitic hepatitis. reporte de una serie de casos in Revista Médica de Chile - 2019. See here.
[4] Pizzarossa, Rebella: Hepatitis in patients with syphilis: an overlooked association in BMJ Case Reports - 2019.
here.
[6] Huang: A systematic literature review of syphilitic hepatitis in adults in Journal of Clinical and Translational Hepatology - 2018. See here.
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