Nephrotic syndrome associated with early neurosyphilis / 대한내과학회지

ABSTRACT

Nephrotic syndrome, hepatitis, and CNS involvement resulting from secondary syphilis are well-documented complications of neurosyphilis. However, the simultaneous occurrence of these complications is rare. The present report describes a 49-year-old male with early neurosyphilis who presented with features of nephritic syndrome and hepatitis. A diagnosis of neurosyphilis was made by CSF study and serologic tests. After the diagnosis of neurosyphilis, nephrotic syndrome and hepatitis were suspected to be factors of the neurosyphilis. A kidney biopsy revealed membranous nephropathy characterized by subepithelial electron dense deposits and diffuse effacement of foot processes. Abdominal ultrasonography showed hepatitis. The patient was treated with intravenous potassium penicillin G, 4 million units for 2 weeks, and the symptoms and signs resolved after the penicillin therapy. In conclusion, complications experienced by patients with a history of syphilis or syphilis lesions need to be minimized through careful observations and multi-organ treatments.