Zieve's syndrome

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief:

Overview

Zieve’s syndrome is an acute metabolic condition that can occur during withdrawal from prolonged alcohol abuse. It is characterized by hemolytic anemia, hyperlipidemia, jaundice, and abdominal pain. The underlying cause is liver delipidation. This is distinct from alcoholic hepatitis which, however, may present simultaneously or develop later.

Historical Perspective

Zieve’s syndrome was initially described by Leslie Zieve in patients with a combination of alcoholic liver disease, hemolytic anemia and hypertriglyceridemia.^[1]

Classification

Pathophysiology

The proposed mechanism of the characteristic haemolytic anaemia in Zieve’s syndrome is due to alteration of the red cell metabolism, namely pyruvate kinase instability leaving them susceptible to circulating hemolysin such as lysolecithin.^[2] Changes in membrane lipid compositions such as increased cholesterol and polyunsaturated fatty acid (PUFA) have been report during the hemolytic phase.^[3]

Causes

Differentiating Zieve’s syndrome from Other Diseases

Epidemiology and Demographics

Risk Factors

Screening

Natural History, Complications, and Prognosis

Natural History

Complications

Prognosis

Diagnosis

Diagnostic Criteria

History and Symptoms

Physical Examination

Laboratory Findings

Imaging Findings

Other Diagnostic Studies

Treatment

Medical Therapy

Definitive treatment for Zieve’s syndrome is alcohol cessation.

Surgery

Prevention

References

↑ ZIEVE L (1958). “Jaundice, hyperlipemia and hemolytic anemia: a heretofore unrecognized syndrome associated with alcoholic fatty liver and cirrhosis”. Annals of Internal Medicine. 48 (3): 471–96. PMID 13521581. Unknown parameter |month= ignored (help)
↑ Melrose, W. D.; Bell, P. A.; Jupe, D. M.; Baikie, M. J. (1990-01-01). “Alcohol-associated haemolysis in Zieve’s syndrome: a clinical and laboratory study of five cases”. Clinical and Laboratory Haematology. 12 (2): 159–167. ISSN 0141-9854. PMID 2208946.
↑ Kunz, F.; Stummvoll, W. (1970-10-01). “The significance of plasma phospholipids in Zieve syndrome”. Blut. 21 (4): 210–226. ISSN 0006-5242. PMID 5531666.

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[pmid13521581-1] ZIEVE L (1958). “Jaundice, hyperlipemia and hemolytic anemia: a heretofore unrecognized syndrome associated with alcoholic fatty liver and cirrhosis”. Annals of Internal Medicine. 48 (3): 471–96. PMID 13521581. Unknown parameter |month= ignored (help)

[2] Melrose, W. D.; Bell, P. A.; Jupe, D. M.; Baikie, M. J. (1990-01-01). “Alcohol-associated haemolysis in Zieve’s syndrome: a clinical and laboratory study of five cases”. Clinical and Laboratory Haematology. 12 (2): 159–167. ISSN 0141-9854. PMID 2208946.

[3] Kunz, F.; Stummvoll, W. (1970-10-01). “The significance of plasma phospholipids in Zieve syndrome”. Blut. 21 (4): 210–226. ISSN 0006-5242. PMID 5531666.

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