Zieve described a syndrome with hemolytic anemia in a patient who has had a heavy intake of alcohol.


Clinical features of Zieve's syndrome:

(1) hemolytic anemia

(2) jaundice

(3) alcoholic steatosis or steatohepatitis or cirrhosis

(4) hyperlipidemia

(5) recent history of heavy alcohol use


Other findings:

(5) abdominal pain

(6) fever



(1) acute renal failure secondary to the hemoglobinuria


Melrose et al associated the hemolysis with an acquired pyruvate kinase deficiency in the red blood cells, resulting in osmotic fragility and autohemolysis.


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