Zieve syndrome, also known as alcoholic hyperlipidemia syndrome, transient hyperlipidemia-hemolytic anemia syndrome with jaundice, or alcoholic hyperlipidemia hemolytic syndrome, was first reported by Zieve in 1958 and named Zieve syndrome by Balcerzak in 1968. It refers to a group of conditions in patients with chronic alcoholism presenting with the triad of jaundice, hyperlipidemia, and hemolytic anemia.

bubble_chart Etiology

The disease is caused by alcohol-induced liver cell damage and varying degrees of gall fel stasis, leading to jaundice. Alcohol can increase plasma free fatty acids and, by enhancing intrahepatic lipid formation, elevate serum triglycerides. Hyperlipidemia alters the lipid composition of red blood cell membranes, resulting in membrane dysfunction and increased fragility, which leads to hemolysis. Additionally, alcohol-induced pancreatitis and vitamin E deficiency are also associated with hemolysis.

bubble_chart Clinical Manifestations

1. It is commonly seen in patients with a long history of alcohol consumption and chronic alcoholism, often presenting with nausea, vomiting, poor appetite, and upper abdominal pain after heavy drinking.

2. Hepatomegaly with moderate texture and tenderness, rarely splenomegaly. Advanced stages may show manifestations of cirrhosis, such as ascites, liver palms, and spider angiomas. Tremor and delirium may occur after stopping alcohol consumption.

3. Yellow staining of the skin and sclera.

4. Manifestations of hemolytic anemia, such as hemoglobinuria and hemosiderinuria.

bubble_chart Auxiliary Examination

1. Blood picture: Hemoglobin decreased, reticulocytes increased. Changes in red blood cell morphology, such as macrocytes, spherocytes, target cells, etc.

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3. Bone marrow examination shows active proliferation of the erythroid system.

4. Elevated blood lipids, particularly cholesterol, phospholipids, and triglycerides.

5. Increased serum bilirubin, elevated alkaline phosphatase, and abnormal liver function.

6. Liver biopsy reveals fatty infiltration and cirrhotic changes. {|105|}

bubble_chart Treatment Measures

Symptoms can disappear after 2-3 weeks of alcohol abstinence, with a high-sugar, high-protein diet, and the use of multivitamins and liver-protective drugs. Additionally, corresponding drug treatments can be administered for jaundice, hyperlipidemia, and hemolytic anemia.