Zieve's Syndrome Presenting With Severe Hypertriglyceridemia

Choudhry, Faiza; Kathawa, Jolian; Kerton, Kelsey; Farshadsefat, Seina; Piper, Marc S.

doi:10.14309/crj.0000000000000133

Cited by 10 publications

(16 citation statements)

References 11 publications

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“…However, it's important to note that almost 50% of patients with Zieve syndrome have been found to have normal lipid profiles. 2 It is hypothesized that deficiency of lipoprotein lipase leads to the transient hyperlipidemia seen in this particular disease. Also, it is not unusual for patients to present with concomitant acute pancreatitis as a result of the hyperlipidemia, which was also present in our patient.…”

Section: Discussionmentioning

confidence: 99%

“…3 Another proposed mechanism behind the hemolysis is vitamin E deficiency, commonly seen in alcoholics, which in turn leads to erythrocyte glutathione deficiency. 2,4 Although Zieve syndrome is considered rare, many believe that it is more common than previously reported. Some studies estimate the incidence to be 1 in 1600 admissions.…”

Section: Discussionmentioning

confidence: 99%

“…Data have shown that treating critically ill patients with steroids often leads to adverse outcomes along with an increased incidence of hospital-acquired infections. 2,6 Other associations seen in Zieve syndrome, although less common, include acute renal failure and myalgias, commonly mistaken for polymyalgia rheumatica due to elevated plasma viscosity. 7 Most documented cases have shown that patients often recover within 5 to 6 weeks following alcohol cessation.…”

Section: Discussionmentioning

confidence: 99%

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Zieve syndrome in acute alcoholic hepatitis

Achufusi

Sandhu

Chahal

et al. 2020

Baylor University Medical Center Proceedings

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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.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Zieve syndrome in acute alcoholic hepatitis

Achufusi

Sandhu

Chahal

et al. 2020

Baylor University Medical Center Proceedings

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“…Применение Гепадифа в комплексной терапии АСГ способствовало устранению или снижению интенсивности основных клинических синдромов (астено-вегетативного, диспепсического, холестатического, гепато-, спленомегалии, стеатоза печени) и биохимических синдромов (мезенхимальновоспалительного, холестаза, ПКН), что превышало по эффективности традиционную терапию в пределах 1,3-4,3 раза (р <0,05), а также высокую эффективность лечения больных АСГ с анемическим синдромом в 6,0 раза (р <0,05).Эффективность эрадикации Н.pylori в основной и контрольной группах с применением 3-компонентной программы первой линии по данным стултеста была одинакова (соответственно 85,7% и 84,2% (р <0,05)), однако в 57,9 % пациентов контрольной группы на фоне антибактериальной терапии Актуальність проблеми ведення пацієнтів із алкогольним стеатогепатитом (АСГ) на тлі хронічної алкогольної інтоксикації полягає в істотному зростанні захворюваності на дану патологію в популяції, а також частої коморбідності з анемічними станами (АС), що вимагає пильної уваги в їх диференціальній діагностиці та диференційованому лікуванні [1,2]. Низкою досліджень доведено статистично значуще взаємообтяження як патогенезу АСГ та АС за їх коморбідності, так і механізмів прогресування АСГ із АС до цирозу печінки (ЦП) [2][3][4][5][6][7][8]. 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].…”

Section: резюмеunclassified

“…Таким [20][21][22][23][32][33][34]. Гепадиф апробований низкою клінічних досліджень із застосуванням у комплексній терапії хронічних гепатитів та стеатогепатитів різної етіології [4,6,[8][9][10][11]28]. Результати досліджень одностайно вказують на високу ефективність, патогенетичну політропність, безпечність препарату.…”

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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An unusual case of Zieve's syndrome in a 36‐year‐old male with latent autoimmune diabetes of adult and disseminated intravascular coagulation

Zalavadiya,

Bhatt,

Nagori

et al. 2024

Clinical Case Reports

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Key Clinical MessageZieve's syndrome, associated with chronic alcoholism, manifests as hemolytic anemia, transient hyperlipidemia, and cholestatic jaundice. Key symptoms comprise nausea, abdominal pain, and jaundice. Diagnosis relies on recognizing the triad in those with an alcohol use history. Supportive management includes blood transfusions and alcohol cessation. The exact pathophysiology remains uncertain, with hypotheses ranging from alcohol‐induced liver damage to autoimmune processes. The report emphasizes diagnostic complexities, particularly when concurrent with autoimmune disorders such as latent autoimmune diabetes of adults or complicated by disseminated intravascular coagulation (DIC). A 36‐year‐old male with latent autoimmune diabetes of adults and an 18‐year history of chronic alcoholism presented with yellowish skin discoloration, abdominal pain, and distension. Physical examination revealed signs of anemia, jaundice, pedal edema, hepatomegaly, splenomegaly, and abdominal tenderness. Over eight admissions, multiple tests revealed severe anemia, thrombocytopenia, elevated bilirubin, and positive autoantibodies. Treatment for suspected autoimmune hepatitis showed no improvement. Subsequent examinations indicated DIC, altered liver function, and cirrhosis progression. A confirmed diagnosis of Zieve's syndrome was made. Upper gastrointestinal endoscopy was done to check for esophageal varices which were banded. The patient was subsequently managed on supportive treatment with multiple blood transfusions and abstinence from alcohol. Prompt recognition of Zieve's syndrome is crucial to avoid unnecessary interventions. Alcohol cessation is the keystone of treatment, emphasizing the need to raise awareness among practitioners. This case points toward the importance of comprehensive evaluation, serial investigations, and multidisciplinary collaboration for accurate diagnosis and management. Further research is needed to enhance understanding and optimize therapeutic strategies.

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Zieve's Syndrome Presenting With Severe Hypertriglyceridemia

Cited by 10 publications

References 11 publications

Zieve syndrome in acute alcoholic hepatitis

Zieve syndrome in acute alcoholic hepatitis

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

An unusual case of Zieve's syndrome in a 36‐year‐old male with latent autoimmune diabetes of adult and disseminated intravascular coagulation

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