Hemolytic Anemia in Alcohol-Induced Liver Disease: A Case Report on Zieve’s Syndrome

Nath, Shefali; Peck, Joshua R.

doi:10.23937/2469-5696/1410011

Cited by 4 publications

(4 citation statements)

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“…Treatment of ZS is mainly supportive with blood transfusions and encouraging abstinence from alcohol [2]. Liver transplantation has been suggested as a treatment if there is no improvement in liver function and hemoglobin despite alcohol abstinence and the patient continues to remain transfusion dependent [13].…”

Section: Discussionmentioning

confidence: 99%

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Zieve’s Syndrome: An Under-reported Cause of Anemia in Alcoholics

Abughanimeh

Kaur

Numan

et al. 2019

Cureus

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Anemia is a common finding in alcoholics. It is often multifactorial and caused by a combination of liver dysfunction, ineffective erythropoiesis, and poor nutrition. Zieve’s syndrome (ZS) is a clinical syndrome that presents with a triad of jaundice, hemolytic anemia, and hyperlipidemia secondary to alcohol use. Herein, we present a case of a 58-year-old male with a history of liver cirrhosis who presented after a fall due to binge drinking and was found to have severe anemia. Workup was consistent with hemolytic anemia with no source of active bleeding. The patient was managed with supportive treatment and blood transfusions which improved his anemia. However, given his advanced liver disease, he developed encephalopathy and subsequently severe aspiration pneumonia. He died 18 days after admission.

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Section: Discussionmentioning

confidence: 99%

“…Patients with ZS present with abdominal pain, nausea, and other nonspecific symptoms [1]. Treatment of ZS includes supportive management with blood transfusion and abstinence from alcohol [2]. ZS is an under-reported cause of acute hemolysis in alcoholics [3].…”

Section: Introductionmentioning

confidence: 99%

Zieve’s Syndrome: An Under-reported Cause of Anemia in Alcoholics

Abughanimeh

Kaur

Numan

et al. 2019

Cureus

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“…However, it is essential to consider that ZS can also present with non-specific symptoms besides the classic triad. Symptoms like nausea, vomiting, abdominal pain, weakness, and low-grade fever can mimic AAH [ 3 , 9 ]. However, a significant difference is that AAH presents with macrocytic anemia, whereas ZS causes non-autoimmune acute hemolytic anemia [ 5 , 6 ].…”

Section: Discussionmentioning

confidence: 99%

A Case of Zieve’s Syndrome With the Development of Delirium Tremens

Nieto¹,

Martinez²,

Narvaez³

et al. 2023

Cureus

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A 50-year-old man presented to the emergency department with dark urine and altered mental status. Upon examination, the patient was found to be jaundiced with normal vitals. Laboratory investigation demonstrated macrocytic anemia and abnormal liver function tests. During his hospitalization, he developed delirium tremens in addition to the discovery of acute hemolytic anemia, hypercholesterolemia, and hypertriglyceridemia. Therefore, he was diagnosed with Zieve's syndrome (ZS), a rarely reported disease characterized by hemolytic anemia, cholestatic jaundice, and transient hyperlipidemia. Physicians encountering acute hemolytic anemia in a patient with concomitant acute liver injury should consider ZS as a differential diagnosis, as prompt recognition of the syndrome can help prevent unnecessary procedures and therapy.

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“…При формуванні синдрому портальної гіпертензії при алкогольному ЦП анемії можуть бути наслідком гіперспленізму або крововтрат на тлі стравохідношлунково-кишкових кровотеч, а також зниження біосинтезу печінкою чинників згортання крові [9][10][11][12][13]. Іншими причинами АС при алкогольному ЦП є дизрегуляція еритропоезу внаслідок зниження біосинтезу еритропоетину внаслідок гепаторенального синдрому, порушення акумуляції заліза та синтезу трансферину в гепатоцитах [9][10][11][12][13][14][15][16][17][18]. У патогенезі АСГ та алкогольного ЦП наявне безпосереднє токсичне ураження кісткового мозку етанолом та продуктами його метаболізму [9][10][11][12].…”

Section: резюмеunclassified

Optimized treatment of patients with alcoholic steatohepatitis taking into account comorbid anaemic conditions and H.pylori contamination

Antofiichuk¹,

Хухліна²,

Антофійчук³

2021

Buk. Med. Herald

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The prospective study of patients with alcoholic steatohepatitis (ASH) showed that 40 % of patients with ASH were diagnosed with anaemic conditions (AC), among which vitamin B12-deficiency anaemia was registered - in 17.5% of cases, anaemia of chronic disease (ACD) – in 10.0% of cases and hemolytic anemia (HA) - in 12.5% of cases. In patients with SH of mixed (including alcoholic) etiology AC was found in 32.0%: vitamin B12 - deficient - in 16.0%, ACD - in 8.0% and hemolytic - in 8.0 % of patients. In patients with ASH, H. pylori contamination was present in 32 (80.0%) individuals, including 100% of patients with B12-deficient anaemia. Among patients with SH of mixed (including alcoholic) etiology, H. pylori was detected in 100.0% of people with AS. The use of Hepadif in the complex therapy of ASH contributed to the elimination or reduction of the intensity of the main clinical syndromes (astheno-vegetative, dyspeptic, cholestatic, hepato-, splenomegaly, hepatic steatosis) and biochemical syndromes (mesenchymal-inflammatory cholestasis, hepatocellular insufficiency), in the range of 1.3-4.3 times (p <0.05), as well as higher efficiency of treatment of patients with ASH with anaemic syndrome in 6.0 times (p <0.05). The efficiency of eradication of H. pylori in the main and control groups accompanied by the use of the 3-component programme of the first line according to the stool test was the same (85.7% and 84.2% (p> 0.05), respectively), but in 57.9 % of patients in the control group, the symptoms of dyspepsia increased or appeared on the background of antibacterial therapy, while no side effects of the drug were found during the study in the main group.

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Hemolytic Anemia in Alcohol-Induced Liver Disease: A Case Report on Zieve’s Syndrome

Cited by 4 publications

References 4 publications

Zieve’s Syndrome: An Under-reported Cause of Anemia in Alcoholics

Zieve’s Syndrome: An Under-reported Cause of Anemia in Alcoholics

A Case of Zieve’s Syndrome With the Development of Delirium Tremens

Optimized treatment of patients with alcoholic steatohepatitis taking into account comorbid anaemic conditions and H.pylori contamination

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