Zieve's syndrome is an uncommonly recognized form of acute haemolytic anemia that manifests as a triad of jaundice, hyperlipidaemia, and alcoholic steatohepatitis
- A combination of jaundice, alcoholic hepatitis, hyperlipidaemia, and haemolysis
- First described in 1957 by Dr. Leslie Zieve.
- Mechanism of haemolysis not entirely understood.
- Alterations in red cell metabolism such as pyruvate kinase instability leave erythrocytes susceptible to circulating haemolysins, such as lysolecithin
- Changes in membrane lipid composition, as indicated by increased cholesterol and polyunsaturated fatty acids may be seen during the haemolytic phase
- Jaundice, RUQ pain due to alcoholic hepatitis
- Alcohol related issues
- FBC: low Hb Increased reticulocytes
- U&E/LFTs: increased bilirubin and deranged LFTS, high LDH, low Haptoglobins
- Blood film: anaemia, spherocytosis is the result of haemolysis.
- Lipids: hyperlipidaemia,
- No specific treatment - supportive therapy is indicated which includes:
- Hydration, Correction of clotting abnormalities
- Treatment of haemolysis
- Treating alcohol withdrawal: Thiamine, Chlordiazepoxide
- Preventing further alcohol intake and adequate nutrition.