A Rare Case of Blindness Caused by Syphilis with Malignant Hypertensive Nephropathy

Minami Matsumoto; Shinya Yamamoto; Takuya Morinishi; Eishin Harima; Shintaro Nakayasu; Nobuki Iwamoto; Yuki Muraoka; Ayako Takahashi; Sachiko Minamiguchi; Motoko Yanagita

doi:10.2169/internalmedicine.1436-22

CASE REPORTS

A Rare Case of Blindness Caused by Syphilis with Malignant Hypertensive Nephropathy

Minami Matsumoto, Shinya Yamamoto, Takuya Morinishi, Eishin Harima, Shintaro Nakayasu, Nobuki Iwamoto, Yuki Muraoka, Ayako Takahashi, Sachiko Minamiguchi, Motoko Yanagita

Author information

Minami Matsumoto
Department of Nephrology, Kyoto University, Japan
Shinya Yamamoto
Department of Nephrology, Kyoto University, Japan
Takuya Morinishi
Department of Nephrology, Kyoto University, Japan
Eishin Harima
Department of Nephrology, Kyoto University, Japan
Shintaro Nakayasu
Department of Neurosurgery, Kyoto University, Japan
Nobuki Iwamoto
Department of Infection Control and Prevention, Kyoto University, Japan
Yuki Muraoka
Department of Ophthalmology and Visual Sciences, Kyoto University, Japan
Ayako Takahashi
Department of Ophthalmology and Visual Sciences, Kyoto University, Japan
Sachiko Minamiguchi
Department of Diagnostic Pathology, Kyoto University, Japan
Motoko Yanagita
Department of Nephrology, Kyoto University, Japan
Institute for the Advanced Study of Human Biology (WPI-ASHBi), Kyoto University, Japan

Keywords: syphilis, neurosyphilis, hydrocephalus, malignant hypertension, hypertensive retinopathy, hypertensive nephropathy

JOURNAL OPEN ACCESS

2023 Volume 62 Issue 21 Pages 3195-3201

DOI https://doi.org/10.2169/internalmedicine.1436-22

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Abstract

The number of patients with syphilis has been rapidly increasing. Without treatment, syphilis can damage various organs and become life-threatening. We herein report a 29-year-old woman diagnosed with neurosyphilis, acute hydrocephalus, syphilitic uveitis combined with hypertensive retinopathy, and malignant hypertensive nephropathy. To our knowledge, this is the first report of syphilis complicated with malignant hypertensive nephropathy proven by a renal biopsy. Neurosyphilis was successfully treated with intravenous penicillin G, and severe hypertension subsequently resolved. However, delayed medical examinations and complications of syphilitic uveitis and hypertensive retinopathy resulted in irreversible visual loss. To prevent irreversible organ damage, early treatment is essential.

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