Zieve's syndrome

Seven patients with Zieve's Syndrome are discussed. All were chronic, heavy alcoholics with mild anaemia, reticulocystosis, mildly abnormal liver functions, elevated serum lipids and fatty infiltration of the liver. Follow-up after abstinence showed normalisation of these values, whereas in one patient alcoholic bin ge produced a flare up of all these abnormalities. The occurrence of this syndrome in Iraq should be thought of particularly on a background of increasing alcoholism

Alcoholic liver disease in Iraq

Alcohol abuse is emerging as a serious cause of liver disease in Iraq. In a prospective study of 72 patients, liver injury was related to the amount and duration of alcohol consumption. Hepatomegaly was found in 79% and stigmata of liver disease in half the patients. Abnormal liver functions were not specific but a high SGOT/SGPT ratio was found in 34% of patients. Gastroscopy demonstrated varices, thus confirming chronic liver disease, in 63% of patients, and revealed various types of gastro-duadenal mucosal lesions in half the patients. Liver biopsy confirmed alcohol-associated liver pathology in all patients. Among other associated diseases, ten patients had diabetes mellitus and two had alcoholic cardiomyopathy which suggest that alcohol abuse can cause multi-system injury

Hepatocellular carcinoma in Iraq

Hepatocellular cancer [HCCA] is not an uncommon tumour. Thirty seven [37] patients with histologically proved lesions are reported. Generalized weakness, abdominal pain and swelling and weight loss were present in 3/4 of patients, as were ascites and hepatomegaly, whereas jaundice was found in 2/3 of patients with ascites but ascetic Fluid examination and liver function tests were not very helpful. HBsAg was detected in 55.6% of patients and alpha feto protein [AFP] in 62.9% of patients. Ultra sound [US] detected hepatic tumours in 90.9% of patients. HCCA was associated with underlying chronic liver disease in 62.2% of patients. HCCA should be considered on clinical suspicion even in patients without evidence of underlying chronic liver disease. Haemorrhagic ascites should raise the suspicion and confirmation is best obtained by US and liver biopsy