[Syphilis hepatitis and liver transplantation].
We report a case of secondary syphilis hepatitis in a liver-transplant patient. This homosexual male patient presented, 15 years after orthotopic liver transplantation, with non-squamous papulomacular rash, mild cytolysis, and anicteric cholestasis. Laboratory tests showed syphilis seroconversion with a venereal diseases research laboratory (VDRL) titer of 1/256, a Treponema pallidum hemaglutination assay (TPHA) of 1/5120, and a positive IgM fluorescent Treponemal antibody absorbance (FTA-abs). A liver biopsy performed 13 months after the diagnosis showed low-grade hepatitis with a Metavir score of A1F1; it also showed non-specific portal moderate inflammation consisting primarily of neutrophils, with no evidence of cholestasis. He was given benzathine-penicillin at 2,400,000 IU with a transient increase in prednisolone doses. Cytolysis rapidly, and cholestasis progressively disappeared. IgM FTA-abs became negative, whereas VDRL and TPHA titers decreased slightly over time.
Camara
B
B
Service de Néphrologie, Dialyse et Transplantation, CHU de Rangueil, 1, avenue Jean-Poulhès, TSA 50032, 31059 Toulouse cedex 09, France.
Kamar
N
N
Bonafe
J-L
JL
Danjoux
M
M
Suc
B
B
Rostaing
L
L
D001379:Azathioprine / Q000009:adverse effects / Q000627:therapeutic use; D016572:Cyclosporine / Q000009:adverse effects / Q000627:therapeutic use; D006505:Hepatitis / Q000209:etiology* / Q000382:microbiology; D006525:Hepatitis, Viral, Human / Q000601:surgery; D006716:Homosexuality; D006801:Humans; D016867:Immunocompromised Host; D007166:Immunosuppressive Agents / Q000009:adverse effects / Q000627:therapeutic use; D008099:Liver / Q000382:microbiology; D016031:Liver Transplantation; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000175:diagnosis / Q000382:microbiology*; D012309:Risk-Taking; D013587:Syphilis / Q000150:complications* / Q000175:diagnosis; D014210:Treponema pallidum / Q000302:isolation & purification
D007166:Immunosuppressive Agents; D016572:Cyclosporine; D001379:Azathioprine