A 31-year-old woman presented with acute alcoholic hepatitis, jaundice, anemia, and hypertriglyceridemia following ethylene glycol poisoning. She had no previous history of anemia or gastrointestinal bleeding. Laboratory findings were consistent with acute hemolytic anemia. She was diagnosed with Zieve syndrome and was managed with supportive measures. Zieve syndrome is a rare occurrence with only a handful of published case reports. Although rare, the diagnosis should be on the differential in this subgroup of patients to avoid unnecessary and invasive diagnostic interventions.
The aim in reporting this case is to highlight the potential effect foscarnet has in inducing NDI. It is important for practitioners to review a patient's medications in detail in patients who develop NDI because missing potential inciting agents can lead to severe electrolyte disturbances and adverse outcomes.Overall, foscarnet is a less common cause of NDI; however it must be kept on the differential for when patients receiving this medication present with the characteristic clinical and laboratory findings of NDI.NDI is a serious side effect for the use of foscarnet in the management of CMV retinitis. However, despite the fact of it being rare to occur, in immunocompromised patients (particularly patients with cancers, as it is the case in our reported patient), NDI is more likely to be reported with a higher rate.
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