Zieve's syndrome

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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.

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. Changes in membrane lipid compositions such as increased cholesterol and polyunsaturated fatty acid (PUFA) have been report during the hemolytic phase.

Treatment

Medical Therapy

Definitive treatment for Zieve's syndrome is alcohol cessation.