Zieve's syndrome, characterized by jaundice, hyperlipaemia and haemolytic 
anaemia, usually develops in young, chronically alcoholic subjects with enlarged 
fatty liver. Hitherto, the course of the disease was considered favourable in 
most patients, with complete regression of clinical, biological and anatomical 
symptoms. However, the discovery of acute alcoholic hepatitis during repeat 
needle-biopsy of the liver confirms that in some cases steatosis may mask 
hyaline necrosis and neutrophil infiltration. Zieve's syndrome therefore is not 
benign but precedes acute alcoholic hepatitis episodes on a normal, fibrotic or 
cirrhotic liver.