隐匿性梅毒伴急性肝炎肾炎1例  

Lurking Syphilitic Hepatitis with Nephritis:A Case Report

作　　者：何芳 练婷婷 寇彩霞 张敏 HE Fang;LIAN Tingting;KOU Caixia;ZHANG Min(Department of Dermatology,Jiangning Hospital,Nanjing 211103,China;Department of Dermatology,Zhongshan Hospital,Fudan University,Shanghai 200032,China;Department of Dermatology,the Second Affiliated Hospital of Nanchang University,Nanchang 330006,China)

机构地区：[1]南京市江宁医院皮肤科,江苏南京211103 [2]复旦大学附属中山医院皮肤科,上海200032 [3]南昌大学第二附属医院皮肤科,江西南昌330006

出　　处：《中国皮肤性病学杂志》2024年第12期1370-1372,共3页The Chinese Journal of Dermatovenereology

基　　金：南京市医学科技发展一般性课题(YKK20198)。

摘　　要：患者男,61岁,全身皮肤及巩膜黄染1周,无二期梅毒疹表现。入院检查提示:总胆红素(TBIL)36.3μmol/L,血清碱性磷酸酶(ALP)1804 U/L,尿蛋白(PRO)(3+),查梅毒血清学阳性,RPR 1∶64。诊断:二期梅毒伴急性肝炎肾炎。排除其他原因所致肝肾损伤后,使用苄星青霉素G治疗,患者转氨酶下降,症状消失。本文提示梅毒除可累及神经和心血管系统之外,还可累及其他脏器,早期诊断和治疗对早期预防器官损害具有重要意义。A 61-year-old male with no secondary syphilis rash was presented with jaundice affecting both the skin and sclera for one week.At the time of admission,laboratory evaluations disclosed an elevated total bilirubin(TBIL)concentration of 36.3μmol/L,a markedly elevated serum alkaline phosphatase(ALP)level reaching 1804 U/L,and urine proteinuria(PRO)indicated as(3+)which indicated nephrotic-range proteinuria.Serological testing confirmed a positive syphilis serology status with a rapid plasma reagin(RPR)titer of 1∶64,leading to a diagnosis of secondary syphilis accompanied by acute hepatitis and nephritis.After excluding other potential causes of liver and kidney damage,the patient was treated with benzathine penicillin G,resulting in a reduction in transaminase levels and resolution of symptoms.This case underscores the fact that syphilis,beyond its well-known neurological and cardiovascular manifestations,can also affect other organs.Early diagnosis and prompt treatment are paramount in preventing further organ damage.

关 键 词：梅毒性肝炎 梅毒性肾炎 二期梅毒 

分 类 号：R759.1[医药卫生—皮肤病学与性病学]