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As a non\u2010hepatotropic pathogen, syphilis can also cause unexplained hepatitis, a condition that is often overlooked. A retrospective review of 62 patients with neurosyphilis at a metropolitan Australian hospital found that nine (15%) had abnormal liver biochemistry, which improved with antibiotic therapy, consistent with syphilitic hepatitis. This improvement was statistically significant across all liver markers, and the liver pattern of injury was predominantly cholestatic (67%). This study aims to alert clinicians to the incidence and patterns of liver biochemistry abnormalities in syphilis and advise clinicians to perform liver function testing in all patients with neurosyphilis, particularly in high\u2010risk groups. Early detection and diagnosis can prevent unnecessary tests, enable prompt treatment and avoid progression to fulminant hepatitis.<\/jats:p>","DOI":"10.1111\/imj.70197","type":"journal-article","created":{"date-parts":[[2025,9,26]],"date-time":"2025-09-26T12:06:32Z","timestamp":1758888392000},"page":"2087-2091","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Incidence of syphilitic hepatitis among patients with neurosyphilis"],"prefix":"10.1111","volume":"55","author":[{"ORCID":"https:\/\/orcid.org\/0009-0009-1986-8225","authenticated-orcid":false,"given":"Jessica","family":"Sun","sequence":"first","affiliation":[{"name":"General Medicine Sydney Hospital and Sydney Eye Hospital  Sydney New South Wales Australia"},{"name":"Prince of Wales Hospital  Sydney New South Wales Australia"},{"name":"School of Clinical Medicine, UNSW Medicine and Health University of New South Wales  Sydney New South Wales Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Louis","family":"Wang","sequence":"additional","affiliation":[{"name":"General Medicine Sydney Hospital and Sydney Eye Hospital  Sydney New South Wales Australia"},{"name":"St Vincent's and Mater Clinical School University of Notre Dame Australia  Sydney New South Wales Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Christopher","family":"Pokorny","sequence":"additional","affiliation":[{"name":"General Medicine Sydney Hospital and Sydney Eye Hospital  Sydney New South Wales Australia"},{"name":"School of Clinical Medicine, UNSW Medicine and Health University of New South Wales  Sydney New South Wales Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2025,9,26]]},"reference":[{"key":"#cr-split#-e_1_2_6_2_1.1","unstructured":"HicksCB ClementM.Syphilis: screening and diagnostic testing. 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Available from URL:https:\/\/www.who.int\/news-room\/fact-sheets\/detail\/syphilis#:~:text=In%202022%2C%20WHO%20estimated%20that with%20men%2C%20including%20congenital%20syphilis"},{"key":"e_1_2_6_17_1","doi-asserted-by":"publisher","DOI":"10.1177\/0956462418785257"}],"container-title":["Internal Medicine Journal"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/imj.70197","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,12,15]],"date-time":"2025-12-15T15:09:18Z","timestamp":1765811358000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/imj.70197"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,9,26]]},"references-count":18,"journal-issue":{"issue":"12","published-print":{"date-parts":[[2025,12]]}},"alternative-id":["10.1111\/imj.70197"],"URL":"https:\/\/doi.org\/10.1111\/imj.70197","archive":["Portico"],"relation":{},"ISSN":["1444-0903","1445-5994"],"issn-type":[{"value":"1444-0903","type":"print"},{"value":"1445-5994","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,9,26]]},"assertion":[{"value":"2025-04-05","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-08-15","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-09-26","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}