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[Zieve's syndrome. A case report]

F J Fernández Pérez1, H Pallarés Manrique, M Cabello Ramírez

  • 1Servicio de Aparato Digestivo, Hospital Universitario Virgen Macarena, Sevilla.

Revista Espanola De Enfermedades Digestivas
|March 1, 1996
PubMed
Summary

Zieve's Syndrome, a rare condition characterized by jaundice, hyperlipidemia, and hemolytic anemia, can occur after significant alcohol consumption. Prompt treatment involving supportive care and dietary changes leads to satisfactory clinical recovery.

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Area of Science:

  • Hepatology
  • Hematology
  • Toxicology

Background:

  • Zieve's Syndrome (ZS) is a rare clinical entity associated with acute alcoholic liver injury.
  • It is characterized by the simultaneous occurrence of jaundice, hyperlipidemia, and hemolytic anemia.

Observation:

  • A 32-year-old female presented with anorexia, asthenia, jaundice, liver stigmata, and hepatomegaly following heavy alcohol intake.
  • Laboratory findings included elevated aminotransferases, hyperbilirubinemia, hyperlipidemia, and normocytic anemia with dianocytes.
  • Liver biopsy revealed acute and chronic alcoholic liver disease.

Findings:

  • The patient's presentation and laboratory results were consistent with Zieve's Syndrome.
  • Hemolysis in ZS is attributed to erythrocyte metabolic and osmotic instability secondary to lipid abnormalities.

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  • Clinical resolution of jaundice and anemia occurred before normalization of serum lipid levels.

    • Implications:

    • This case highlights the importance of recognizing Zieve's Syndrome in patients with a history of significant alcohol consumption and the characteristic triad of symptoms.
    • Early diagnosis and management, including supportive care and dietary modifications, are crucial for favorable outcomes.
    • Understanding the pathogenetic link between alcohol, lipid abnormalities, and hemolysis is key to managing this syndrome effectively.