Abstract
We present a rare case of a patient diagnosed with both primary biliary cholangitis (PBC) and secondary syphilis during hospitalization. While the coexistence of these two conditions is uncommon, distinguishing between syphilitic hepatitis and autoimmune liver disease is critical. This case highlights the importance of thorough history-taking, a comprehensive workup for cholestatic liver disease, and the potential diagnostic overlap between infectious and autoimmune processes.