Sifiliz ile ilişkili kolestatik hepatit: Bir olgu sunumu
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Tarih
2012
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info:eu-repo/semantics/openAccess
Özet
Sifilizde, karaciğer tutulumu nadirdir ve hastalığın evrelerine göre değişkenlik gösterir. Karaciğer enzimlerindeki belirgin yüksekliklere rağmen sarılık genellikle görülmez. Bu yazıda, biz ikinci evre sifilizli bir olguda kolestatik hepatit sunduk. Altmış üç yaşında erkek hasta ateş yüksekliği, vücutta yaygın döküntü, halsizlik, yorgunluk, kas-eklem ağrıları, iştahsızlık, kilo kaybı, öksürük ve gece terlemesi yakınmalarıyla polikliniğimize başvurdu. Hastanın döküntü şikayetinin 2 gün önce başladığı diğer şikayetlerinin üç haftadır devam ettiği öğrenildi. Fizik muayenesinde; ateş 38.1°C, tüm vücutta makülopapüler döküntü, servikal ve inguinal bölgede lenfadenopatiler, sağ üst kadranda palpasyonla ağrılı hepatomegali saptandı. Laboratuvar bulgularında karaciğer enzimlerinde artış belirlendi. Sifilize yönelik istenen tetkiklerden VDRL 1/32 ve TPHA 1/1280 titrede pozitif tespit edildi. Viral hepatit belirteçleri negatif sonuç verdi. Hastaya sifiliz tanısı konuldu ve tek doz Benzatin Penisilin G verildi. Bir hafta sonra klinik bulguları düzeldi. Üç hafta sonra karaciğer fonksiyon testleri normale geriledi. Biz kolestatik hepatitin ayırıcı tanısında sifilizin göz önünde bulundurulması gerektiğini düşünüyoruz.
The Liver involvement in syphilis patients is rare and varies according to the stage of the disease. Despite marked elevations of the liver enzymes are usually no visible jaundice. In this paper, we presented cholestatic hepatitis in a patient with secondary stage syhilis. A 63 year old male patient was presented to our clinic with complaints fever, rash, myalgia, arthralgia, anorexia, weight loss, widespread rash on the body, cough, and night sweats. It was learned rash complaint of the patient had been started two days ago, other complaints continued for three weeks. On physical examination, fever was 38.1°C, maculopapular rash on the all body, cervical and inguinal lymphadenopathies, hepatomegaly, hepatomegali with painful by palpation on the right upper quadrant. On Laboratory findings, liver enzymes were highly determined. Diagnostic tests for syphilis, VDRL 1/32 and TPHA 1/1280 titer were positive. Markers of viral hepatitis were negative. We diagnosed as syphilis and a single dose of penicillin G benzathine were given. The clinical signs of the patient improved a week later and liver function tests were normal three weeks later. We think that syphilis group should be considered in the differential diagnosis of cholestatic hepatitis.
The Liver involvement in syphilis patients is rare and varies according to the stage of the disease. Despite marked elevations of the liver enzymes are usually no visible jaundice. In this paper, we presented cholestatic hepatitis in a patient with secondary stage syhilis. A 63 year old male patient was presented to our clinic with complaints fever, rash, myalgia, arthralgia, anorexia, weight loss, widespread rash on the body, cough, and night sweats. It was learned rash complaint of the patient had been started two days ago, other complaints continued for three weeks. On physical examination, fever was 38.1°C, maculopapular rash on the all body, cervical and inguinal lymphadenopathies, hepatomegaly, hepatomegali with painful by palpation on the right upper quadrant. On Laboratory findings, liver enzymes were highly determined. Diagnostic tests for syphilis, VDRL 1/32 and TPHA 1/1280 titer were positive. Markers of viral hepatitis were negative. We diagnosed as syphilis and a single dose of penicillin G benzathine were given. The clinical signs of the patient improved a week later and liver function tests were normal three weeks later. We think that syphilis group should be considered in the differential diagnosis of cholestatic hepatitis.
Açıklama
Anahtar Kelimeler
Kolestatik Hepatit, İkinci Evre, Sifiliz, Döküntü, Cholestatic Hepatitis, Secondary Stage, Syphilis, Rash
Kaynak
Okmeydanı Tıp Dergisi
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Scopus Q Değeri
Cilt
28
Sayı
2
