An analysis of the clinical features of children with early congenital Syphilis and Syphilitic Hepatitis

Hongling Yang,Huimin Zhang,Lin Pang,Caiying Wang

doi:10.1186/s12887-021-02932-5

Hongling Yang, Huimin Zhang + Show 2 more

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https://doi.org/10.1186/s12887-021-02932-5

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Journal: BMC Pediatrics	Publication Date: Nov 9, 2021
Citations: 4	License type: open-access

Affiliation: Capital Medical University, Beijing Ditan Hospital

Abstract

BackgroundThe infection rate of congenital syphilis is gradually increasing, the clinical manifestations of some children with congenital syphilis are abnormal liver function, which is given the clinical diagnosis of syphilitic hepatitis. At present, there are few studies on the clinical features of children with early congenital syphilis combined with syphilitic hepatitis, so we set out to do such a study. We compared the liver function indicators before and after the treatment of syphilis to find the clinical features that can provide guidance for clinical diagnosis and treatment.MethodsThis study collected clinical data on 51 children with early congenital syphilis combined with syphilitic hepatitis in Beijing Ditan Hospital, affiliated with Capital Medical University, between April 2014 and October 2019. We observed their age, gender, clinical symptoms, and physical symptoms, as well as the pregnancy and childbirth history of their mothers. We also compared the liver function indicators before and after the treatment of the syphilis and analyzed the children’s clinical features.ResultsThe results of this study showed that the clinical manifestations in children with early congenital syphilis combined with syphilitic hepatitis were diverse. The most common clinical manifestation was anemia (56.9 %), followed by syphilitic rash (54.9 %), hands, feet, and whole-body peeling (35.3 %), and splenomegaly (29.4 %). Liver damage caused by a syphilis infection tends to result in elevated alanine aminotransferase, aspartate aminotransferase, and bilirubin, while albumin decreases. After the syphilis treatment, the liver function indexes were significantly improved compared with before treatment, and the difference was statistically significant (all p < 0.05).ConclusionsA child with abnormal liver function, especially with anemia, skin rash, peeling, abdominal distension, and hepatosplenomegaly should be highly suspected of having a syphilis infection. Once the diagnosis is made, the appropriate standard penicillin treatment should be started as soon as possible to improve the condition and prognosis of the child.

Highlights

The infection rate of congenital syphilis is gradually increasing, the clinical manifestations of some children with congenital syphilis are abnormal liver function, which is given the clinical diagnosis of syphilitic hepatitis
This study focused on children with early congenital syphilis combined with syphilitic hepatitis who were admitted to the Department of Pediatrics, Beijing Ditan Hospital Affiliated to Capital Medical University between April 2014 and October 2019
2.2 Inclusion and exclusion criteria The inclusion criteria were as follows: (1) all selected cases met the diagnostic criteria of the 2010 Centers for Disease Control and Prevention diagnosis and treatment guidelines [10] and the diagnostic criteria for congenital syphilis issued by the Ministry of Health of CHINA [11] and were diagnosed as patients with early congenital syphilis combined with abnormal liver function and syphilitic hepatitis; The patients were diagnosed according to the clinical signs of illness, quantitative nontreponemal serum test, examination of the cerebrospinal fluid and liver function tests. (2) the patient was 0–14 years old

Summary

Introduction

The infection rate of congenital syphilis is gradually increasing, the clinical manifestations of some children with congenital syphilis are abnormal liver function, which is given the clinical diagnosis of syphilitic hepatitis. Congenital syphilis is a chronic systemic infectious disease caused by Treponema pallidum infecting the fetus through the placenta [1,2,3]. It can be divided into early congenital syphilis (0–2-year-old child) and late congenital syphilis (a child over two years). Treponema pallidum can invade all organs of the body and cause multiple organ damage. Syphilitic hepatitis is liver damage caused by Treponema pallidum, which mostly occurs in late syphilis. Neonatal congenital syphilis can affect the skin, liver, kidneys, pancreas, spleen, lungs and intestines, as well as causing hematopoiesis outside of the bone marrow

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