CD40LG and syphilis: Initial aminotransferases (alanine aminotransferase, ALT; aspartate aminotransferase, AST), total bilirubin, and alkaline phosphatase were elevated, while hepatitis panel (HBsAg, anti-HBcore, anti-HAV, anti-HIV, CMV IgM, and syphilis) was negative, and the patient's health continued to worsen in the next two months and finally he developed signs of liver failure and was transferred to Spain for hepatic transplantation.