Isolated “puffy hands” following COVID-19: clue to a long-term capillary leakage syndrome?

Background: Burns induce a boost in local and systemic complement levels as well as immune cell infiltration in the burn wound, that may negatively affect wound healing. Objective: In this study, the effects of long-term treatment with complement inhibitor C1 esterase inhibitor (C1inh) on post-burn inflammation and wound healing parameters were analyzed in time up to 60 days post-burn. Method: Burned pigs were treated either with or without C1inh up to 15 days post-burn. Burn wound biopsies and blood were collected at different time points up to 60 days post-burn. Thereafter, complement in blood as well as complement and immune cells in the wound, capillary leakage, necrosis, reepithelialization and wound contraction were quantified. Results: No significant differences in complement C3 blood levels were observed at any time point between C1inh-treated and control pigs. In the wound, complement C4 levels were significantly lower in the C1inh group than in controls at day 3-6 and 21-30 post-burn. Similarly, C3 levels, neutrophil and macrophage infiltration in the wound were, although not statistically significant, reduced in C1inh-treated pigs at day 9-14 post-burn. No differences in lymphocyte infiltration in the wound were found between C1inh and control pigs. C1inh-treated pigs also showed reduced capillary leakage. Despite these effects, no significant differences in the long-term wound healing parameters necrosis, reepithelialization and wound contraction were observed between C1inh and control pigs. Conclusion:: In pigs 15 days of C1inh treatment after burn, leads to a reduction in local inflammation and capillary leakage in the burn wound without affecting long-term wound healing parameters.

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Capillary leakage syndrome: diabetes mellitus

Archives of Dermatology ◽

10.1001/archderm.96.5.589 ◽

1967 ◽

Vol 96 (5) ◽

pp. 589-591 ◽

Cited By ~ 1

Author(s):

R. Fleischmajer

Keyword(s):

Diabetes Mellitus ◽

Capillary Leakage ◽

Capillary Leakage Syndrome

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Risk factors for capillary leakage syndrome after bone marrow transplantation

Annals of Hematology ◽

10.1007/s002770050288 ◽

1997 ◽

Vol 74 (5) ◽

pp. 221-224 ◽

Cited By ~ 56

Author(s):

W. Nürnberger ◽

R. Willers ◽

S. Burdach ◽

U. Göbel

Keyword(s):

Risk Factors ◽

Bone Marrow ◽

Bone Marrow Transplantation ◽

Marrow Transplantation ◽

Capillary Leakage ◽

Capillary Leakage Syndrome

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TREATMENT OF CAPILLARY LEAKAGE SYNDROME (CLS) USING C1-ESTERASE INHIBITOR CONCENTRATE

Shock ◽

10.1097/00024382-199703001-00293 ◽

1997 ◽

Vol 7 (Supplement) ◽

pp. 73

Author(s):

W. Nürnberger ◽

S. Burdach ◽

U. Göbel

Keyword(s):

Capillary Leakage ◽

C1 Esterase Inhibitor ◽

Esterase Inhibitor ◽

Capillary Leakage Syndrome

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Could systemic capillary leakage syndrome post-episodic recovery light-up our knowledge about less evident and less known key properties of the lymphatic system?

MOJ Immunology ◽

10.15406/moji.2018.06.00218 ◽

2018 ◽

Vol 6 (5) ◽

Author(s):

Diego Liberati

Keyword(s):

Lymphatic System ◽

Capillary Leakage ◽

Capillary Leakage Syndrome

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Interleukin 11 Induced Capillary Leakage Syndrome and Deteriorated Hemorrhagic Cystitis in an Acute Myelogenous Leukemia Patient after Allo-HSCT.

Blood ◽

10.1182/blood.v110.11.4997.4997 ◽

2007 ◽

Vol 110 (11) ◽

pp. 4997-4997

Author(s):

Xuemei Sun ◽

Yonggong Yang ◽

Chaoyang Guan ◽

Xiaohui Li

Keyword(s):

Renal Failure ◽

Acute Renal Failure ◽

Acute Myelogenous Leukemia ◽

Hemorrhagic Cystitis ◽

Myelogenous Leukemia ◽

Capillary Leakage ◽

Urinary Volume ◽

Acute Myelogenous ◽

Interleukin 11 ◽

Capillary Leakage Syndrome

Abstract Interleukin 11 (IL11) has been approved for clinical utilization by Chinese Drug and Food Administration in the treatment of thrombopenia post chemo/radio therapy. It has been proved a safe cytokine in previous clinical trials. We however found a case who presented with a severe syndrome which was suspected in relation with IL 11. A 38- year-old male was undertaken a matched unrelated peripheral blood stem cell transplantation after an ablative BuCy conditioning for the treatment of acute myelogenous leukemia. He suffered from hemorrhagic cystitis(HC) on day 40 and was managed well with aggressive hydration and diuresis as well as administration of anti-virus regimen. After a resultant pancytopenia occurred, he was given IL11 for the amelioration of the thrombocytopenia in aid of controlling the bladder bleeding. His HC was in good control initially, but two days after the IL-11 administering, the patient manifested with generalized edema, hypotension with hemoconcentration and hypoalbuminemia without albuminuria. The diagnosis of capillary leakage syndrome (CLS) was under consideration. Interleukin 11 was ceased immediately and 6% hydroxyethly starch(HES) was added to improve the symptoms of CLS. In the following day the 24 hour- urinary volume of the patient reduced sharply accompanying by dysuresia. Ultrasonic examination displayed a clumping mass measured 50 mm×75mm ×63mm. Three days later, he was diagnosed as acute renal failure owing to combination factors of the renal and/or postrenal damage of the kidney. Meanwhile continuous renal replacement therapy (CRRT) was started and patient got well 5 days later with normal urinary volume. And symptoms from HC and CLS were improved dramatically. We concluded here that interleukin 11 could play the pivotal role in inducing a CLS and resultant acute renal failure. And it thus deteriorated HC in this patient. The patient’s renal function could recover well rapidly with the infusion of HES and CRRT. We suggested a comprehensive clinical study of Interleukin 11 be conducted to optimize its clinical usage for the sake of safe medication.

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