Kidney or liver involvement in syphilis is quite rare. The patient described here had both nephrotic syndrome and granulomatous hepatitis during secondary syphilis.
Report of a Case
A 29-year-old man was admitted to the Brooklyn Veterans Administration Hospital on Jan 26,1976 with a two-week history of fever, night sweats, and nonpruritic rash, and a two-day history of pedal edema.Physical examination showed a comfortable young man with normal vital signs. There were papulosquamous lesions on the abdomen, elbows, and penis, generalized lymphadenopathy, and hepatosplenomegaly.The WBC count was 7,000/cu mm. The VDRL was positive at 1:256. The fluorescent treponemal antibody-absorption test was positive. Results of urinalysis showed 4+ proteinuria, without casts or hematuria. Results of laboratory studies disclosed the following values: 24-hour urine protein, 5.7 g/dl; serum protein, 5.7 g/dl; albumin, 2.3 g/dl; cholesterol, 238 mg/dl; and alkaline phosphatase, 323 μU/ml. Results of the following tests were within normal limits:
Bansal RC, Cohn H, Fani K, Lynfield YL. Nephrotic Syndrome and Granulomatous Hepatitis in Secondary Syphilis. Arch Dermatol. 1978;114(8):1228-1229. doi:10.1001/archderm.1978.01640200080025