Resumo:
Introduction: Neonatal cholestasis is a condition characterized by reduced bile flow
during the first months of life and represents a diagnostic emergency in pediatrics. Among
its multiple etiologies, congenital syphilis stands out as a vertically transmitted infection
capable of causing significant hepatic involvement and systemic manifestations.
Association with other congenital infections may worsen hepatobiliary dysfunction and
prolong the clinical course. Early diagnosis and timely treatment are essential to prevent
hepatic complications and reduce neonatal morbidity and mortality. Methods: This is an
observational, descriptive, retrospective cohort study based on data obtained from
medical record review of patients aged 0 to 3 months with a confirmed diagnosis of
congenital syphilis and associated hepatic involvement (cholestasis), who were
hospitalized at a university hospital in the state of Bahia, Brazil, in 2024. Results: The
sample consisted of eight patients, with a predominance of males (75%), whose clinical
and laboratory manifestations of cholestasis occurred early, within the first 15 days of
life. Jaundice was the most frequent clinical finding, associated with elevated
transaminases, bilirubin levels, and alkaline phosphatase. Time to resolution ranged from
2 to 5 months and was longer in cases associated with neurosyphilis, hypothyroidism,
infections, or prematurity. Only one patient required invasive investigation due to
persistent acholic stools. Discussion/Conclusions: A predominance of males and variable
clinical presentation were observed, with jaundice as the main finding, not always
accompanied by classic signs of obstructive cholestasis. The laboratory profile showed a
mixed biochemical pattern, often associated with infections and concomitant conditions
such as hypothyroidism and neurosyphilis. Overall evolution was favorable, with gradual
resolution within five months and low need for invasive procedures. These findings
reinforce the multifactorial nature of neonatal cholestasis and the importance of a
comprehensive, conservative, and individualized diagnostic approach.
