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

Abughanimeh, Omar; Kaur, Anahat; Numan, Laith; Bahaj, Waled; Madhusudhana, Sheshadri

doi:10.7759/cureus.4121

Cited by 11 publications

(19 citation statements)

References 9 publications

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“…Although most cases included in our review were able to abstain from alcohol and fully recover, our patient experienced multiple relapses and ultimately succumbed to her illness. This highlights the importance of alcohol abstinence in the recovery from ZS [8].…”

Section: Discussionmentioning

confidence: 79%

Zieve’s Syndrome: an Unusual Cause of Anemia

Twohig

Desai

Sandhu

2020

SN Compr. Clin. Med.

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Zieve's syndrome (ZS) is a rare condition that includes alcoholic hepatitis, hyperlipidemia, and hemolytic anemia. We describe a severe case of ZS in a 39-year-old female patient with refractory symptoms who ultimately succumbed to her liver injury 6 weeks from her initial presentation to the hospital despite multiple attempts at alcohol cessation rehabilitation. Clinicians need to maintain a high index of suspicion for ZS in patients with alcoholic hepatitis who have transfusion refractory anemia. Alcohol abstinence is essential for recovery. The major challenge with this syndrome remains early diagnosis, and our goal is that increased case reporting will raise clinician awareness.

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Section: Discussionmentioning

confidence: 79%

Zieve’s Syndrome: an Unusual Cause of Anemia

Twohig

Desai

Sandhu

2020

SN Compr. Clin. Med.

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“…One study has found a partial improvement in serum lipids after plasmapheresis [ 15 ]. Though all patients with SCA had higher reticulocyte count, it was not proportionately high, suggesting some degree of ineffective erythropoiesis due to advanced liver disease and alcoholism [ 16 ].…”

Section: Discussionmentioning

confidence: 99%

Spur Cells Causing Severe and Transfusion-Refractory Anemia in Patients With Acute-on-Chronic Liver Failure

Kedarisetty¹,

Kumar²

2020

Cureus

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Acute-on-chronic liver failure (ACLF) is characterized by acute decompensation of chronic liver disease associated with organ failures. Anemia of diverse etiology is common in patients with ACLF. Spur cell anemia (SCA) is a form of acquired hemolytic anemia that occurs rarely in such patients due to dysregulated lipids metabolism. Spur cells are large erythrocytes with spike-like projections, which predispose them for sequestration and destruction in splenic canaliculi. There is a paucity of data on SCA in patients with ACLF. Here we report a series of five ACLF patients who had severe (hemoglobin level < 8 g/dL) and transfusionrefractory SCA with aggressive clinical course and high mortality rate.

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“…The mechanism of hemolysis of this syndrome is not fully understood in the literature, but they believe it is related to a change in the metabolism of red blood cells, so that erythrocytes are more susceptible to circulating hemolysins (SHUKLA, S.; SISITRIN, M., 2015). In addition, vitamin E deficiency, induced by alcohol, can decrease the levels of polyunsaturated fatty acids and cause oxidation of erythrocyte glutathione, which leads to instability of this enzyme and erythrocyte hemolysis (ABUGHANIMEH, K., et al, 2019).…”

Section: Discussionmentioning

confidence: 99%

“…Patients with this syndrome may have a higher alcoholic hepatitis score, thus contributing to excessive treatment with the use of corticosteroids and the possibility of inducing immunosuppression and promoting unnecessary additional complications. It can be seen, then, that the lack of knowledge of this pathology at first is one of the challenges faced in the management of these patients (ABUGHANIMEH, K., et al, 2019).…”

Section: Discussionmentioning

confidence: 99%

Zieve's Syndrome: a case report /Síndrome de Zieve: um relato de caso

Paiva

Cabral²,

Costa

et al. 2020

BJHR

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Alcoholism is prevalent throughout the Americas, it affects an average of 10% of the population, therefore it can be considered a public health problem. Alcohol abuse can cause several injuries to the metabolism, being responsible for causing liver damage and other complications. Zieve's syndrome (ZS) is considered an example of these insults, it represents a rare condition and is generally underdiagnosed in clinical practice. The rarity of this syndrome means that patients are often submitted to unnecessary exams due to the lack of knowledge of this possible diagnosis by the medical team. It should be suspected whenever there is anemia, elevation of indirect bilirubin and secondary hyperlipidemia in the context of acute and abusive alcohol intake, without any obvious sign of gastrointestinal bleeding. In this article we discuss a case report about ZS of a patient attended at a metropolitan hospital in Belo Horizonte.

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

Cited by 11 publications

References 9 publications

Zieve’s Syndrome: an Unusual Cause of Anemia

Zieve’s Syndrome: an Unusual Cause of Anemia

Spur Cells Causing Severe and Transfusion-Refractory Anemia in Patients With Acute-on-Chronic Liver Failure

Zieve's Syndrome: a case report /Síndrome de Zieve: um relato de caso

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