Revisiting contemporary laboratory characteristics of patients with syphilis: insights from a multicenter study

Abstract

Despite the persistent susceptibility of Treponema pallidum to penicillin, the global incidence of syphilis remains high. Syphilis is a complex disease with physical consequences extending beyond manifestations. In this multicenter case–control study, we analyzed data from 536 patients with syphilis who underwent complete blood cell analysis, biochemical examination, and coagulation function tests at the First Affiliated Hospital Zhejiang University School of Medicine and People’s Hospital of Hangzhou Medical College in China. Moreover, we included 84 bone marrow-derived stem cell donors in the control group. Our findings indicated that patients with syphilis exhibited macrocytic anemia, coagulation abnormalities, multiple organ dysfunction, reduced anabolism and glucose metabolism, and electrolyte imbalance. Notably, HIV infection was noted to exacerbate coagulation disorders and liver injury in patients with syphilis. Furthermore, patients with neurosyphilis demonstrated decreases in the levels of hemostasis and anabolism. The aforementioned laboratory-based pathogenic features represent a contemporary understanding of syphilis progression. As such, when administering anti-T. pallidum treatment to patients with syphilis, particularly those exhibiting penicillin allergy and latent syphilis, medical professionals should address the associated physical damage.