Fernández Pérez F J, Pallarés Manrique H, Cabello Ramírez M, Piñar Moreno A L, Rebollo Bernárdez J, Jiménez Sáenz M, Herrerías Gutiérrez J M
Servicio de Aparato Digestivo, Hospital Universitario Virgen Macarena, Sevilla.
Rev Esp Enferm Dig. 1996 Mar;88(3):226-9.
We report a case of Zieve's Syndrome that developed after an important alcohol consumption in a 32-yr-old female patient. She was admitted to the hospital with anorexia, asthenia and jaundice. Physical examination showed liver stigmata and hepatomegaly. Laboratory tests demonstrated increased aminotransferase levels, hyperbilirubinemia, hyperlipidemia and normocytic and normochromic anemia with dianocytes in peripheral blood smear. Ultrasonography showed a hyperechoic liver and a liver biopsy showed acute and chronic alcoholic liver disease. Clinical evolution was satisfactory and the therapy consisted of blood transfusion, parenteral fluids, B-complex vitamin and a fatty free diet. Jaundice, hyperlipidemia and haemolytic anemia define Zieve's Syndrome (Z.S.) There is a pathogenetic relationship among the clinical and biological phenomena in this syndrome, whose starter is an acute alcohol intake. Haemolysis is the distinctive feature with respect to the classical acute alcoholic hepatitis, and it is due to erythrocyte's metabolic and osmotic instability in relation to lipids abnormalities. Its clinical resolution precedes the normalization of serum lipids levels. Therapy is similar to that for acute alcoholic hepatitis although sometimes the anemia requires blood transfusion.
我们报告一例32岁女性患者在大量饮酒后发生齐夫综合征的病例。她因厌食、乏力和黄疸入院。体格检查发现肝脏体征和肝肿大。实验室检查显示转氨酶水平升高、高胆红素血症、高脂血症以及外周血涂片出现异形红细胞的正细胞正色素性贫血。超声检查显示肝脏回声增强,肝脏活检显示急性和慢性酒精性肝病。临床病程进展顺利,治疗包括输血、静脉补液、复合维生素B和无脂饮食。黄疸、高脂血症和溶血性贫血构成齐夫综合征(Z.S.)。该综合征的临床和生物学现象之间存在发病机制上的关联,其起始因素为急性酒精摄入。溶血是相对于经典急性酒精性肝炎的显著特征,它是由于红细胞代谢和渗透压不稳定与脂质异常有关。其临床缓解先于血脂水平正常化。治疗与急性酒精性肝炎相似,尽管有时贫血需要输血。