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Zieve syndrome presenting with lipaemia and treated by plasmapheresis
  1. Lauren Eleonore Sams1,
  2. Julia Krappe2,
  3. Michael Czihal3 and
  4. John Michael Hoppe2
  1. 1Division of Cardiology, Medizinische Klinik und Poliklinik I, LMU Klinikum, Munchen, Germany
  2. 2Division of Nephrology, Medizinische Klinik und Poliklinik IV, LMU Klinikum, Munich, Germany
  3. 3Division of Angiology, Medizinische Klinik und Poliklinik IV, LMU Klinikum, Munich, Germany
  1. Correspondence to Dr John Michael Hoppe; john.hoppe{at}


Zieve syndrome is a rare condition which occurs in patients with severe alcohol abuse. It is typically characterised by the triad of jaundice, haemolytic anaemia and transient hyperlipidaemia. In the following report, we present the case of a man in his 30s who was admitted to our emergency department with severe epigastric pain and signs of alcohol intoxication. Blood samples showed signs of severe hyperlipidaemia and jaundice. Due to massive hyperlipidaemia, laboratory measurements of triglycerides were impaired and the blood samples had a ‘yellowish’ and ‘creamy’ texture. In order to prevent pancreatitis, plasmapheresis was performed. Subsequently, triglyceride concentration dropped and the patient was discharged a few days later in significantly improved physical condition. In the following case report, we discuss plasmapheresis as a possible treatment for patients with severe Zieve syndrome in addition to conventional symptomatic therapy.

  • Alcoholic liver disease
  • Lipid disorders
  • Pancreatitis

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  • Contributors LES, JK, MC and JMH contributed to the implementation of the case and to the analysis of the results. LS wrote the manuscript with support from MC and JMH. All authors were directly involved in the patient’s care.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Case reports provide a valuable learning resource for the scientific community and can indicate areas of interest for future research. They should not be used in isolation to guide treatment choices or public health policy.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.