Syphilis Infection Triggering Autoimmune Hepatitis.

Syphilis is a systemic infection that can involve multiple organ systems, including the liver. Distinguishing between syphilitic hepatitis (SH) and autoimmune hepatitis (AIH) can be challenging, as both present with overlapping clinical, serologic, and histological features. We present a rare case of secondary syphilis acting as a potential trigger for AIH in a 42-year-old man. This case highlights how Treponema pallidum infection may unmask or exacerbate underlying immune dysregulation in susceptible individuals. SH was excluded based on clinical and pathologic correlation, including histology consistent with AIH and the absence of features supporting SH. Early recognition and appropriate treatment are pertinent, as the management of AIH differs from that of SH. The patient achieved sustained biochemical remission after corticosteroid therapy.