Congenital syphilitic cirrhosis

Introduction to congenital syphilitic cirrhosis Syphilis is a chronic sexually transmitted disease caused by the pallidum, Treponema pallidum. It can invade skin, mucous membranes and many other tissues and organs. It can have a variety of clinical manifestations, and sometimes it is asymptomatic latent state. Pathogens can transmit fetal syphilis through the placenta to the fetus. 80% of patients with congenital syphilis are involved in the liver. It may be that the Treponema pallidum passes through the placenta, enters the umbilical vein and finally reaches the liver. The serology of children with congenital syphilis is positive. Clinical manifestations include loss of appetite, weight loss, abdominal pain, diarrhea, bleeding gums, nosebleeds, fever, jaundice, splenomegaly, abdominal varices, and peritoneal effusion. basic knowledge Sickness ratio: 5% Susceptible people: young children Mode of infection: vertical infection of mother and baby Complications: upper gastrointestinal bleeding, ascites, hepatic encephalopathy

Congenital syphilitic cirrhosis etiology

Cause:

The pathological changes of this type of hepatitis are like hepatitis A, with hepatocyte balloon-like changes, punctate or focal necrosis and inflammatory cell infiltration in the portal area, mainly lymphocytes and mononuclear macrophages, with obvious cholestasis, observed by electron microscopy. It indicates that hepatocyte damage may be associated with T cell-mediated immune response.

Congenital syphilitic cirrhosis prevention

The disease is caused by congenital syphilis. Without effective preventive measures, it should actively respond to the call of eugenics and excellent education to improve the quality of the population. It is best for women infected with syphilis to give birth after the cure, or to prevent infection during pregnancy and during the production process.

Congenital syphilitic cirrhosis complications Complications upper gastrointestinal bleeding, ascites, hepatic encephalopathy

Can be complicated by electrolyte imbalance, upper gastrointestinal bleeding, ascites, hyponatremia, hepatic encephalopathy.

Congenital syphilitic cirrhosis symptoms common symptoms fatigue jaundice hepatomegaly liver lobe atrophy liver failure splenomegaly nausea skin itching abortion hepatic stellate cell hyperplasia

According to clinical characteristics, liver function tests, reference to epidemiological data, to exclude acute liver damage caused by HAV, HBV, HCV infection and other causes.

The incubation period is 10 to 60 days, with an average of 40 days. According to the survey of three epidemics of hepatitis E in China, the incubation period is 15 to 75 days, with an average of 36 days. Adult infections are mostly clinical, children are subclinical, clinical symptoms and liver. Functional damage is heavier, generally subclinical, clinical symptoms and liver function damage are heavier, generally onset is acute, jaundice is more common, half have fever, accompanied by fatigue, nausea, vomiting, liver pain, about 1/3 Joint pain, common cholestasis, such as itchy skin, light stool color is more obvious than hepatitis A, most hepatomegaly, splenomegaly is rare, most patients with jaundice subsided in about 2 weeks, the course of disease is 6 to 8 weeks, Generally do not develop chronic, pregnant women with HEV disease, prone to liver failure, especially in the third trimester of high mortality (10% to 39%), can be seen abortion and stillbirth, the reason may be related to low serum immunoglobulin levels.

HBsAg-positive people are over-infected with HEV, and their condition is aggravated, which is easy to develop into acute severe hepatitis.

Congenital syphilitic cirrhosis

Specific serum pathogens are the basis for diagnosis.

1. Enzyme-linked immunosorbent assay (ELISA): detection of anti-HEV IgM in serum, as an indicator for the diagnosis of acute hepatitis E, using recombinant or synthetic peptides as antigens, domestic application of this method to detect 111 cases of acute hepatitis E, anti- The positive rate of HEV was 86.5%. The positive rate of anti-HEV was 6.3% in 32 patients with recovery. The duration of anti-HEV was shorter, and 63% of them were negative after 5 to 6 months.

2. Western Blot (WB): This method is more sensitive and specific than ELISA, but the operation method is more complicated and the detection time is longer.

3. Polymerase Chain Reaction (PCR): used to detect HEV-RNA in serum and feces of patients with hepatitis E. This method has high sensitivity and specificity, but it is prone to laboratory contamination during operation. False positive.

4. Immunoelectron microscopy (IEM) and immunofluorescence (IF): for the detection of HEV particles and HEV antigen (HEAg) in feces, bile and liver tissue of patients with hepatitis E, but both methods require special equipment and techniques. And HEV has a shorter time in liver tissue, bile and feces, and the positive rate is lower, which is not suitable for routine examination.

Diagnosis and diagnosis of congenital syphilitic cirrhosis

According to the medical history, clinical manifestations and laboratory data is not difficult to make a diagnosis.

It should be differentiated from acute liver damage caused by HAV, HBV, HCV infection and other causes.

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