{
  "abstract": "A 34-year-old female presented with refractory epigastric pain and vomiting for one month. Physical examination revealed epigastric tenderness without cutaneous lesions. Laboratory tests showed hypoalbuminaemia (33 g/L), and Helicobacter pylori testing (13C-UBT) was negative. Syphilis serology confirmed Treponema pallidum infection (TRUST+, TPPA 1:128). An upper gastrointestinal barium study demonstrated thickened, disorganised gastric mucosa with hypomotility and delayed emptying. Gastroscopy revealed extensive antral mucosal denudation with ulceration, bleeding and rigidity (figure 1). Histopathological examination revealed significant lymphocyte infiltration, small vascular proliferation and perivascular infiltration of numerous lymphocytes, plasma cells and neutrophils (figure 2). Histopathological features were consistent with early syphilis, and gastric cancer, mucosa-associated lymphoid tissue (MALT) lymphoma and gastric tuberculosis were excluded. The patient received benzathine penicillin for syphilis treatment. Follow-up endoscopy at 8 weeks post-treatment showed gastric mucosal healing (figure 3), with TPPA titre declining to 1:4. Combined with serological results and the efficacy of penicillin therapy, a diagnosis of gastric syphilis was confirmed.",
  "authors": [
    {
      "affiliations": [
        "Department of Gastroenterology, The Third People’s Hospital of Chengdu, Chengdu, Sichuan, China"
      ],
      "name": "Xi Zhou"
    },
    {
      "affiliations": [
        "Department of Pathology, The Third People’s Hospital of Chengdu, Chengdu, Sichuan, China"
      ],
      "name": "Yuanyuan Chen"
    },
    {
      "affiliations": [
        "Department of Gastroenterology, The Third People’s Hospital of Chengdu, Chengdu, Sichuan, China"
      ],
      "name": "Jing Shan"
    },
    {
      "affiliations": [
        "Department of Gastroenterology, The Third People’s Hospital of Chengdu, Chengdu, Sichuan, China"
      ],
      "name": "Xiaobin Sun"
    }
  ],
  "title": "Rare culprit behind a gastric antrum ulcer",
  "uid": "436820f5-8f81-51aa-9702-2892db0c4680"
}