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Systemic capillary leak syndrome associated with pleural effusion  [cached]
Derya Girgin,Nazan Dalg??,Leyla Telhan,?hsan Kafadar
Turk Pediatri Ar?ivi , 2010,
Abstract: Systemic capillary leak syndrome presents with recurrent episodes of shock due to leakage of the plasma, which is reflected by accompanying hemoconcentration, hypoalbuminemia and edema. We report the case of a 12-year-old girl with hypovolemic shock with generalized edema and pleural effusion. An initial diagnosis of sepsis was made, but the lack of fever and absence of a demonstrable organism or source led to a revision of the diagnosis to systemic capillary leak syndrome. We emphasize the importance of early diagnosis and of prompt and aggressive fluid replacement. (Turk Arch Ped 2010; 45: 61-3)
Consideraciones acerca del síndrome de capillary leak sistémico Issues about systemic capillary leak syndrome  [cached]
B. Besteiro Grandío,A. Vázquez González,M. Madruga Garrido,M. Mourelo Fari?a
Medicina Intensiva , 2012,
Abstract:
Systemic Capillary Leak Syndrome as an Initial Presentation of ALK-Negative Anaplastic Large Cell Lymphoma
Laura S. Lourdes,Samer Z. Al-Quran,Nam H. Dang,Merry-Jennifer Markham
Case Reports in Hematology , 2012, DOI: 10.1155/2012/954201
Abstract: Systemic capillary leak syndrome (SCLS) is a rare disease characterized by third spacing of plasma into the extravascular compartment, leading to anasarca, hemoconcentration, and hypovolemic shock. It has been rarely associated with lymphomas, and reports usually indicate that it occurs after antineoplastic treatment. We present the case of a patient with ALK-negative anaplastic large cell lymphoma who presented with SCLS as the initial manifestation of her lymphoma. The SCLS resolved with treatment of the malignancy with steroids and chemotherapy.
Systemic Capillary Leak Syndrome associated with hypovolemic shock and compartment syndrome. Use of transpulmonary thermodilution technique for volume management
Bernd Saugel, Andreas Umgelter, Friedrich Martin, Veit Phillip, Roland M Schmid, Wolfgang Huber
Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine , 2010, DOI: 10.1186/1757-7241-18-38
Abstract: Systemic Capillary Leak Syndrome (SCLS) is a rare disorder characterized by unexplained, often recurrent, non sepsis-related episodes of increased capillary hyperpermeability leading to hypovolemic shock due to a markedly increased shift of fluid and protein from the intravascular to the interstitial space. Hemoconcentration, hypoalbuminemia and a monoclonal gammopathy (IgG class monoclonal gammopathy predominates, with either kappa or lambda light chains) are the characteristic laboratory findings. SCLS was first described in 1960 by Clarkson et al. [1]. Common clinical manifestations of SCLS are diffuse swelling, weight gain, renal shut-down and hypovolemic shock. Here we present a patient who suffered from SCLS with hypovolemic shock and compartment syndrome of both lower legs and thighs. In this patient volume and catecholamine management was guided using transpulmonary thermodilution.A 41-year-old male with compartment syndrome of both lower legs and thighs was transferred to our intensive care unit (ICU) (hospital B) after emergency decompressive fasciotomy in another hospital (hospital A) the previous day (fig. 1).On admission to hospital A the previous day the patient had presented with severe muscle pain in the legs and a 2-week history of flu-like illness and sore throat with fever up to 39°C, which had been treated with moxifloxacin for several days. On initial physical examination signs of massive dehydration were present (heart rate 102/min; blood pressure 65/50 mmHg, temperature 37.1°C).Extensive fluid resuscitation was initiated (15 L on hospital day 1). Previous medical history was unremarkable. The patient was working as a policeman and had been to Italy three weeks prior to admission. He reported playing in a football tournament one week previously.Blood biochemistry indicated severe hemoconcentration (hemoglobin 22.3 g/dL, hematocrit 60.4%), hypoproteinemia (serum total protein 2.3 g/dL) and acute kidney failure (creatine 1.6 mg/dL, blood urea nit
Systemic Capillary Leak Syndrome as an Initial Presentation of ALK-Negative Anaplastic Large Cell Lymphoma  [PDF]
Laura S. Lourdes,Samer Z. Al-Quran,Nam H. Dang,Merry-Jennifer Markham
Case Reports in Hematology , 2012, DOI: 10.1155/2012/954201
Abstract: Systemic capillary leak syndrome (SCLS) is a rare disease characterized by third spacing of plasma into the extravascular compartment, leading to anasarca, hemoconcentration, and hypovolemic shock. It has been rarely associated with lymphomas, and reports usually indicate that it occurs after antineoplastic treatment. We present the case of a patient with ALK-negative anaplastic large cell lymphoma who presented with SCLS as the initial manifestation of her lymphoma. The SCLS resolved with treatment of the malignancy with steroids and chemotherapy. 1. Introduction Systemic capillary leak syndrome (SCLS) is a rare disease, first described in 1960 by Clarkson et al. [1] It is characterized by third spacing plasma into the extravascular compartment, leading to intravascular volume depletion and giving rise to anasarca, hemoconcentration, and hypovolemic shock. Although about 126 cases are described in the literature, less than ten are lymphomas with SCLS as the presenting feature [2]. We report a case of a patient with ALCL who presents with SCLS that subsequently resolves with steroid therapy followed by chemotherapy. 2. Case Presentation A 71-year-old African American woman presented with a one-week history of lower extremity and facial swelling, nausea, vomiting, and diarrhea. On admission, she was noted to have hypotension (systolic blood pressure 70?mmHg), acute renal failure (blood urea nitrogen 51?mg/dL and serum creatinine 4.99?mg/dL), and hypoalbuminemia (albumin 3?mg/dL). She required fluid and vasopressor resuscitation. Empiric treatment with broad-spectrum antibiotics was started. By hospital day 14, she developed anasarca, 60 pound weight gain, and required additional vasopressor support and continuous veno-venous hemodialysis (CVVH). Evaluations revealed negative or normal blood and urine cultures, quantitative immunoglobulins; serum protein electrophoresis and immunofixation studies, antinuclear antibody, antineutrophil cytoplasmic antibody, anti-double-stranded DNA levels; erythrocyte sedimentation rate. Urine sodium was less than 25?mmol/L, and urine creatinine was 205?mg/dL. She demonstrated adequate response to cosyntropin. Transthoracic echocardiography and right heart catheterization revealed normal left ventricular ejection fraction, normal pulmonary artery wedge pressure, and no pulmonary hypertension. Computed tomography (CT) revealed left inguinal and retroperitoneal lymphadenopathy (largest node measuring 2.2?cm). Positron emission tomography showed hypermetabolic activity of left pelvic lymph nodes. Histopathology from
The Current Opinions of Capillary Leak Syndrome  [PDF]
Jun Su, Ying Zhang, Wei Hu
Open Journal of Clinical Diagnostics (OJCD) , 2015, DOI: 10.4236/ojcd.2015.51003
Abstract: Capillary Leak Syndrome (CLS) in patients with severe course of disease is more and more common, and the clinical manifestations of CLS include systemic edema, hypoproteinemia, effective circulating blood volume reduction and hemoconcentration. The common pathogenies are sepsis, severe trauma, cardiopulmonary bypass and so on. Clinically, CLS is usually divided into leakage period and recovery period, with different pathophysiologic process, clinical manifestation and treatment in different period respectively. Although there are more treatments, they are not effective treatment measures. There have been so many studies about improvement of endothelial function, macromolecular colloid liquid applications, and continuous blood purification treatment. Systematic understanding of the pathological mechanism, clinical manifestations and staging, diagnosis and treatment of the CLS has a guiding value.
A single but prolonged and eventually fatal episode of capillary leak syndrome with a diagnosis of a small tumor mass B cell lymphoma  [PDF]
Majorie Schlier,Murielle Rondeau-Lutz,Jean-Christophe Weber
Journal of Advances in Internal Medicine , 2014, DOI: 10.3126/jaim.v3i1.10702
Abstract: The capillary leak syndrome is a rare and serious condition. It is characterized by acute episodes of extravasation of liquids and proteins through the capillary wall to the interstitial space, with generalized edema, hemoconcentration, hypoproteinemia. Most often, capillary leak syndrome is idiopathic. Some cases are associated with neoplastic diseases. We describe a new case of capillary leak syndrome as a paraneoplastic syndrome of a large-B-cell lymphoma. This case is unusual because of the evolution of the capillary leak syndrome during a single but extended and fatal episode. The etiologic diagnosis in this case was particularly difficult to prove because of the small tumour mass. Our case report is thus the fourth reported case of capillary leak syndrome revealing a B-cell lymphoma with a small tumour mass. DOI: http://dx.doi.org/10.3126/jaim.v3i1.10702 ? Journal of Advances in Internal Medicine 2014;03(01):34-37
Interleukin-11-induced capillary leak syndrome in primary hepatic carcinoma patients with thrombocytopenia
Wang Kai-Feng, Pan Hong-Ming, Lou Hai-Zhou, Shen Li-Rong, Zhu Xi-Yan
BMC Cancer , 2011, DOI: 10.1186/1471-2407-11-204
Abstract: We describe two cases of CLS after IL-11 administration in two males with thrombocytopenia. Case 1 was a 46-year-old man with recurrence of hepatic carcinoma who was treated with IL-11 (3 mg per day). After four days of therapy, hypotension and hypoproteinemia were detected. The chest X-ray and B ultrasound of the abdomen showed pleural effusion and ascites. IL-11 was then discontinued, fluid resuscitation was performed, and fresh frozen plasma and packed red blood cells were transfused into this patient. The patient had recovered after 19 days of treatment.Case 2 was a 66-year-old man who had undergone radiofrequency ablation (RFA) for hepatic carcinoma. He was treated with IL-11 (3 mg per day) for thrombocytopenia. After two days of therapy, this patient complained of dyspnea with bilateral edema of the hands. Laboratory values showed hypoproteinemia. IL-11 was stopped and human albumin was transfused at a rate of 10 g per day. On the 4th day, fluid resuscitation was performed. The patient had recovered after treatment for two weeks.The detection of IL-11-induced CLS supports the hypothesis that CLS could be a severe side effect of IL-11 treatment in some patients. These two case reports also demonstrate that patients with hepatic carcinoma who experience this rare form of CLS after treatment with IL-11 seem to respond to a therapeutic regimen that involves hydroxyethyl starch, albumin, and diuretic therapy. Liver cancer patients might be more susceptible to CLS because of poor liver function and hypersplenia. In addition, bleeding after RFA might be a further inducer of CLS.Capillary leak syndrome (CLS) is a rare clinical syndrome that was first described in 1960. In the vast majority of cases, it is characterized by acute episodes of generalized edema, hemoconcentration, and hypoproteinemia. The cause of CLS is unknown, and the condition is probably under recognized because of its nonspecific symptoms and signs and high mortality rate. Up to and including 1990,
重症肺炎合并毛细血管渗漏综合征1例
One case of severe pneumonia with capillary leak syndrome
 [PDF]

彭娟,黄炜,胥方元
PENG Juan
,HUANG Wei,XU Fangyuan

- , 2015, DOI: 10.3969/j.issn.1671-9638.2015.06.019
Abstract: 毛细血管渗漏综合征(capillary leak syndrome,CLS)是一种突发的、可逆性毛细血管高渗透性,血浆迅速从血管渗透到组织间隙,引起迅速出现的进行性全身性水肿、低蛋白血症、血压及中心静脉压降低、体重增加、血液浓缩,严重时可发生多器官衰竭。CLS的出现,给临床治疗带来困难,同时也是影响抢救成功的因素之一。近期,本院收治1例重症肺炎合并CLS的患者,现将其诊治情况报告如下
LUPUS ERITEMATOSO SISTéMICO SíNDROME DE CUSHING Y PSIQUIATRíA DE ENLACE Erythematous systemic lupus, Cushing`s syndrome and psychiatric  [cached]
Ludwig Pájaro Silva
Revista Facultad de Medicina de la Universidad Nacional de Colombia , 2005,
Abstract: Se presenta el caso de una paciente con diagnóstico de lupus eritematoso sistémico y síndrome de Cushing quien presentó síntomas afectivos de características depresivas e insomnio de conciliación, quien recibió múltiples tratamientos farmacológicos con pobre respuesta inicial. La psiquiatría de enlace consolida una alternativa de tratamiento multidisciplinario para una aproximación más eficiente a las patologías médicas con síntomas psiquiátricos. We present a case of systemic erythematosus lupus and Cushing's syndrome who has affective symptoms of depressive characteristic and insomnia and multiple pharmacological treatments with poor response. The intervention by psychiatry liaison is an alternative of multidisciplinary treatment for an efficient approximation of medical pathologies with psychiatric symptoms.
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