Zieve's syndrome: Difference between revisions
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==Overview== | ==Overview== | ||
Zieve's syndrome is an acute metabolic condition that can occur during withdrawal from prolonged alcohol abuse. | Zieve's syndrome is an acute metabolic condition that can occur during withdrawal from prolonged [[alcohol abuse]]. It is characterized by [[hemolysis|hemolytic anemia]], [[hyperlipidemia]], [[jaundice]], and [[abdominal pain]]. The underlying cause is liver delipidation. This is distinct from [[hepatitis#Alcoholic hepatitis|alcoholic hepatitis]] which, however, may present simultaneously or develop later. | ||
==Historical Perspective== | |||
Zieve's syndrome was initially described by Leslie Zieve in patients with a combination of [[alcoholic liver disease]], [[hemolytic anemia]] and [[hypertriglyceridemia]].<ref name="pmid13521581">{{cite journal | author = ZIEVE L | title = Jaundice, hyperlipemia and hemolytic anemia: a heretofore unrecognized syndrome associated with alcoholic fatty liver and cirrhosis | journal = [[Annals of Internal Medicine]] | volume = 48 | issue = 3 | pages = 471–96 | year = 1958 | month = March | pmid = 13521581 | doi = | url = http://www.annals.org/article.aspx?volume=48&page=471 | issn = }}</ref> | |||
==Classification== | |||
==Pathophysiology== | |||
The proposed mechanism of the characteristic haemolytic anaemia in Zieve's syndrome is due to alteration of the red cell metabolism, namely pyruvate kinase instability leaving them susceptible to circulating [[hemolysin]] such as [[Lysophosphatidylcholine|lysolecithin]].<ref>{{Cite journal|last=Melrose|first=W. D.|last2=Bell|first2=P. A.|last3=Jupe|first3=D. M.|last4=Baikie|first4=M. J.|date=1990-01-01|title=Alcohol-associated haemolysis in Zieve's syndrome: a clinical and laboratory study of five cases|url=http://www.ncbi.nlm.nih.gov/pubmed/2208946|journal=Clinical and Laboratory Haematology|volume=12|issue=2|pages=159–167|issn=0141-9854|pmid=2208946}}</ref> Changes in membrane lipid compositions such as increased [[cholesterol]] and [[polyunsaturated fatty acid]] (PUFA) have been report during the hemolytic phase.<ref>{{Cite journal|last=Kunz|first=F.|last2=Stummvoll|first2=W.|date=1970-10-01|title=The significance of plasma phospholipids in Zieve syndrome|url=http://www.ncbi.nlm.nih.gov/pubmed/5531666|journal=Blut|volume=21|issue=4|pages=210–226|issn=0006-5242|pmid=5531666}}</ref> | |||
==Causes== | |||
==Differentiating {{PAGENAME}} from Other Diseases== | |||
==Epidemiology and Demographics== | |||
==Risk Factors== | |||
==Screening== | |||
==Natural History, Complications, and Prognosis== | |||
===Natural History=== | |||
===Complications=== | |||
===Prognosis=== | |||
==Diagnosis== | |||
===Diagnostic Criteria=== | |||
===History and Symptoms=== | |||
===Physical Examination=== | |||
===Laboratory Findings=== | |||
===Imaging Findings=== | |||
===Other Diagnostic Studies=== | |||
==Treatment== | |||
===Medical Therapy=== | |||
Definitive treatment for Zieve's syndrome is alcohol cessation. | |||
===Surgery=== | |||
===Prevention=== | |||
==References== | ==References== | ||
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[[Category:Hepatology]] | [[Category:Hepatology]] | ||
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Latest revision as of 15:38, 20 July 2016
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief:
Overview
Zieve's syndrome is an acute metabolic condition that can occur during withdrawal from prolonged alcohol abuse. It is characterized by hemolytic anemia, hyperlipidemia, jaundice, and abdominal pain. The underlying cause is liver delipidation. This is distinct from alcoholic hepatitis which, however, may present simultaneously or develop later.
Historical Perspective
Zieve's syndrome was initially described by Leslie Zieve in patients with a combination of alcoholic liver disease, hemolytic anemia and hypertriglyceridemia.[1]
Classification
Pathophysiology
The proposed mechanism of the characteristic haemolytic anaemia in Zieve's syndrome is due to alteration of the red cell metabolism, namely pyruvate kinase instability leaving them susceptible to circulating hemolysin such as lysolecithin.[2] Changes in membrane lipid compositions such as increased cholesterol and polyunsaturated fatty acid (PUFA) have been report during the hemolytic phase.[3]
Causes
Differentiating Zieve's syndrome from Other Diseases
Epidemiology and Demographics
Risk Factors
Screening
Natural History, Complications, and Prognosis
Natural History
Complications
Prognosis
Diagnosis
Diagnostic Criteria
History and Symptoms
Physical Examination
Laboratory Findings
Imaging Findings
Other Diagnostic Studies
Treatment
Medical Therapy
Definitive treatment for Zieve's syndrome is alcohol cessation.
Surgery
Prevention
References
- ↑ ZIEVE L (1958). "Jaundice, hyperlipemia and hemolytic anemia: a heretofore unrecognized syndrome associated with alcoholic fatty liver and cirrhosis". Annals of Internal Medicine. 48 (3): 471–96. PMID 13521581. Unknown parameter
|month=ignored (help) - ↑ Melrose, W. D.; Bell, P. A.; Jupe, D. M.; Baikie, M. J. (1990-01-01). "Alcohol-associated haemolysis in Zieve's syndrome: a clinical and laboratory study of five cases". Clinical and Laboratory Haematology. 12 (2): 159–167. ISSN 0141-9854. PMID 2208946.
- ↑ Kunz, F.; Stummvoll, W. (1970-10-01). "The significance of plasma phospholipids in Zieve syndrome". Blut. 21 (4): 210–226. ISSN 0006-5242. PMID 5531666.