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August 1978

Nephrotic Syndrome and Granulomatous Hepatitis in Secondary Syphilis

Author Affiliations

From the Departments of Medicine (Drs Bansal and Cohn), Pathology (Dr Fani), and Dermatology (Dr Lynfield), Veterans Administration Hospital, Brooklyn, NY, and the Departments of Medicine (Dr Cohn), Pathology (Dr Fani), and Dermatology (Dr Lynfield), State University of New York, Downstate Medical Center, Brooklyn, NY.

Arch Dermatol. 1978;114(8):1228-1229. doi:10.1001/archderm.1978.01640200080025

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: