Syphilis-related hepatitis in a liver transplant patient.
We herein describe a case of secondary syphilis hepatitis in a liver transplant patient. This homosexual man presented 15 years after an orthotopic liver transplant with nonsquamous papillomacular rash, mild cytolysis, and anicteric cholestasis. Laboratory tests showed syphilis seroconversionwith a VDRL test titer of 1/256, a Treponema pallidum hemagglutination assay of 1/5120, and a positive immunoglobulin M fluorescent Treponemal antibody absorbance. A liver biopsy performed 13 months after the diagnosis showed low-grade hepatitis with a METAVIR score of A1F1; it also showed moderate, nonspecific portal inflammation consisting primarily of neutrophils, with no evidence of cholestasis. The patient was given benzathine-penicillin (2400000 IU) with a transient increase in prednisolone dosages. Cytolysis rapidly, and cholestasis progressively, disappeared. Results of an immunoglobulin M fluorescent Treponemal antibody absorbance test became negative, whereas the VDRL test and the Treponema pallidum hemagglutination assay titers decreased slightly over time.
Camara
Boubou
B
Department of Nephrology, CHU Rangueil, Toulouse, France.
Kamar
Nassim
N
Bonafe
Jean-Louis
JL
Danjoux
Marie
M
Suc
Bertrand
B
Rostaing
Lionel
L
D006525:Hepatitis, Viral, Human / Q000382:microbiology* / Q000821:virology; D006801:Humans; D016031:Liver Transplantation; D008297:Male; D008875:Middle Aged; D013587:Syphilis / Q000382:microbiology / Q000821:virology*; D014210:Treponema pallidum / Q000302:isolation & purification