Zieve Syndrome: A Clinical Triad, or Perchance a Quartet?

Reyes, Jonathan Vincent M.; Ahmad, Saad; Majeed, Hafsa; Kandoth, Eugenio; Lieber, Joseph

doi:10.1177/23247096221121393

Cited by 2 publications

(6 citation statements)

References 19 publications

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“…Given the hemolytic nature of anemia, labs generally reveal elevated reticulocyte count, increased lactate dehydrogenase (LDH), and decreased haptoglobin, with elevations in direct bilirubin and alkaline phosphatase. Coomb’s test is also negative [ 12 ]. The clinical importance of recognizing this syndrome comes from the fact that most patients rapidly recover within weeks of alcohol cessation [ 13 ].…”

Section: Discussionmentioning

confidence: 99%

Unique Variant of Zieve Syndrome With a Normal Reticulocyte Count

et al. 2023

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Zieve syndrome is a rare diagnosis seen in patients with chronic alcohol use which consists of a distinct clinical triad of hyperlipidemia, hemolytic anemia, and jaundice. Patients typically have an elevated reticulocyte count due to the hemolytic nature of the anemia. We present the case of a 44-year-old female who was discovered to have an unusual variant of Zieve syndrome with a normal reticulocyte count, which was believed to be due to suppression of bone marrow from excessive alcohol consumption. She was treated with steroids and complete alcohol cessation, with remarkable improvement on subsequent follow-up. An exhaustive literature review of 31 documented cases of Zieve syndrome was conducted to better understand the clinical presentation and overall prognosis of these patients. This case report and literature review aimed to improve patient outcomes through increased recognition of this underrecognized syndrome.

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Section: Discussionmentioning

confidence: 99%

Unique Variant of Zieve Syndrome With a Normal Reticulocyte Count

et al. 2023

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“…Some estimates suggest an incidence rate as notable as 1 in 1600 admissions. 5,6 In this scenario, the patient's coexisting autoimmune disorder, hemolytic anemia, hepatobiliary dysfunction, chronic alcoholism, and esophageal varices collectively supported the diagnosis of Zieve's syndrome. Also, as in our case the stool occult blood testing were negative, another case report stated that medical professionals should maintain a strong clinical suspicion for Zieve syndrome when dealing with individuals who have a confirmed record of excessive alcohol consumption and exhibit symptoms like hemolytic normocytic anemia and hyperbilirubinemia and no evidence of upper GI bleeding.…”

Section: Discussionmentioning

confidence: 83%

“…However, due to the prevalent and persistent excessive alcohol consumption, it's believed that the actual occurrence of this condition might be higher than reported. Some estimates suggest an incidence rate as notable as 1 in 1600 admissions 5,6 …”

Section: Discussionmentioning

confidence: 99%

“…Recognizing Zieve's syndrome promptly is crucial to prevent unwarranted and potentially detrimental interventions 5,12 . With alcohol cessation being the cornerstone of Zieve's syndrome treatment, raising awareness among practitioners about its clinical features, and management becomes paramount.…”

Section: Discussionmentioning

confidence: 99%

“…Recognizing Zieve's syndrome promptly is crucial to prevent unwarranted and potentially detrimental interventions. 5 , 12 With alcohol cessation being the cornerstone of Zieve's syndrome treatment, raising awareness among practitioners about its clinical features, and management becomes paramount. Early identification can spare patients from ineffective or potentially harmful therapies, focusing instead on the most effective approach—abstinence from alcohol.…”

Section: Discussionmentioning

confidence: 99%

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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 Syndrome: A Clinical Triad, or Perchance a Quartet?

Cited by 2 publications

References 19 publications

Unique Variant of Zieve Syndrome With a Normal Reticulocyte Count

Unique Variant of Zieve Syndrome With a Normal Reticulocyte Count

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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