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The Korean Journal of Medicine 2009;77(1): 162-167.
조기 신경매독에 동반된 막성 신병증 1예
김종윤, 고정해, 이원동, 문치숙, 김영훈, 강미선, 김양욱
Nephrotic syndrome associated with early neurosyphilis
Jong Yoon Kim, Jung Hae Ko, Won Dong Lee, Chi Sook Moon, Yeong Hoon Kim, Mi Sun Kang, Yang Wook Kim
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.
Keywords: Hepatitis; Nephrotic syndrome; Neurosyphilis; Syphilis
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