Simultaneous acute nephrosis and hepatitis in secondary syphilis

Simultaneous occurrence of acute nephrosis and hepatitis in secondary syphilis is rare. We report a 24-year-old man who presented with sudden onset of nephrotic syndrome, acute hepatitis, and skin lesions associated with secondary syphilis. A renal biopsy demonstrated electron-dense deposits located in the subepithelial, mesangial and intramembranous areas under electron microscopy. Light microscopy revealed a mild increase in mesangial matrix with normal glomerular cellularity. Immunofluorescent examination showed granular deposition of IgG and IgA along the glomerular capillary basement membrane without deposits of complements. These morphological changes differed from those reported previously. All, the heavy proteinuria, disturbances of liver function, and skin lesions resolved after 4-week treatment.