GPT and Decreased liver function: The persistent neonatal cholestasis in our case may be a result of the common intersection of multiple factors including syphilitic hepatitis, nonsyndromatic paucity of intrahepatic bile ducts,[14] immaturity of the newborn liver, intestinal failure because of meconium obstruction, and total parenteral nutrition.[15] The penicillin therapy aggravated the liver dysfunction from syphilitic hepatitis, as shown by serum ALT levels specifically responding to penicillin dose changes (Table 1).