A case report of capillary leak syndrome with recurrent pericardial and pleural effusions

Abstract Background Capillary leak syndrome (CLS) is a rare connective tissue disease, triggered by the leak of serous fluid into the interstitial spaces, characterized by a hallmark of oedema and effusions in confined spaces. The limiting factor in CLS management appears to be its diagnosis rather than treatment, which is usually to contain the disease progression rather than a cure. Case summary We report a case of a 51-year-old woman with recurrent life-threatening presentations of pericardial effusions, pleural effusions, and generalized swelling of face and extremities. The only notable past medical history was of Type 1 diabetes. Numerous investigations did not lead to specific disease accounting for pericardial effusions and pleural effusions. Eventually, the diagnosis of CLS was made based on hypovolaemic shock, hypoalbuminaemia, and haemoconcentration without the presence of albuminuria. She was managed with steroids to reduce system inflammation and later with immunoglobulins and tumour necrosis factor to contain the disease process. Since her diagnosis and subsequent appropriate management, she has not had further admissions with cardiac tamponade 16 months of follow-up. Discussion The diagnosis of CLS is difficult to make unless there is a high degree of suspicion and until other causes have been ruled out. It remains a challenging condition to manage as the treatment options are limited and patients recurrently present with emergencies until the correct diagnosis is made and the optimal treatment is provided.

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Continuous renal replacement therapy rescued life-threatening capillary leak syndrome in an extremely-low-birth-weight premature: a case report

Italian Journal of Pediatrics ◽

10.1186/s13052-021-01067-8 ◽

2021 ◽

Vol 47 (1) ◽

Author(s):

Li-Fen Yang ◽

Jia-Chang Ding ◽

Ling-Ping Zhu ◽

Li-Xia Li ◽

Meng-Qi Duan ◽

...

Keyword(s):

Birth Weight ◽

Renal Replacement Therapy ◽

Low Birth Weight ◽

Continuous Renal Replacement Therapy ◽

Replacement Therapy ◽

Therapeutic Option ◽

Capillary Leak Syndrome ◽

Extremely Low Birth Weight ◽

Capillary Leak ◽

Life Threatening

Abstract Background Capillary leak syndrome (CLS) is a rare disease characterized by profound vascular leakage and presents as a classic triad of hypotension, hypoalbuminemia and hemoconcentration. Severe CLS is mostly induced by sepsis and generally life-threatening in newborns, especially in premature infants. Continuous renal replacement therapy (CRRT) plays an important role of supportive treatment for severe CLS. Unfortunately, CRRT in preterm infants has rarely been well defined. Case presentation We report the case of a 11-day-old girl with CLS caused by sepsis, who was delivered by spontaneous vaginal delivery (SVD) at gestational age of 25 weeks and 4 days, and a birth weight of 0.89 Kilograms(kg). The infant received powerful management consisting of united antibiotics, mechanical ventilation, intravenous albumin and hydroxyethyl starch infusion, vasoactive agents, small doses of glucocorticoids and other supportive treatments. However, the condition rapidly worsened with systemic edema, hypotension, pulmonary exudation, hypoxemia and anuria in about 40 h. Finally, we made great efforts to perform CRRT for her. Fortunately, the condition improved after 82 h’ CRRT, and the newborn was rescued and gradually recovered. Conclusion CRRT is an effective rescue therapeutic option for severe CLS and can be successfully applied even in extremely-low-birth-weight premature.

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Lower Urinary Tract Neoplasia

Veterinary Sciences ◽

10.3390/vetsci5040096 ◽

2018 ◽

Vol 5 (4) ◽

pp. 96 ◽

Cited By ~ 4

Author(s):

Maureen Griffin ◽

William Culp ◽

Robert Rebhun

Keyword(s):

Urinary Tract ◽

Urinary Bladder ◽

Lower Urinary Tract ◽

Treatment Options ◽

Transitional Cell ◽

Companion Animals ◽

Disease Process ◽

Life Threatening ◽

Comparative Model ◽

Lower Urinary

Lower urinary tract neoplasia in companion animals is a debilitating and often life-threatening disease. Tumors of the bladder, urethra, and prostate often occur independently, although extension of these tumors into adjacent regions of the lower urinary tract is documented frequently. The most common lower urinary tract tumor in dogs and cats is transitional cell carcinoma (TCC). In both dogs and cats, TCC affecting the urinary bladder is generally considered to be highly aggressive with both local and metastatic disease potential, and this disease poses unique treatment challenges. Whereas much literature exists regarding the TCC disease process, treatment options, and prognosis in dogs, relatively few studies on feline TCC have been published due to the lower incidence of TCC in this species. Prostate tumors, most commonly adenocarcinomas, occur less commonly in dogs and cats but serve an important role as a comparative model for prostate neoplasia in humans. This article serves as a review of the current information regarding canine and feline lower urinary tract neoplasia as well as the relevance of these diseases with respect to their human counterparts.

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Hereditary angioedema: an update on causes, manifestations and treatment

British Journal of Hospital Medicine ◽

10.12968/hmed.2019.80.7.391 ◽

2019 ◽

Vol 80 (7) ◽

pp. 391-398 ◽

Cited By ~ 5

Author(s):

Hilary J Longhurst ◽

Konrad Bork

Keyword(s):

Quality Of Life ◽

Hereditary Angioedema ◽

Genetic Disorder ◽

Treatment Options ◽

Correct Diagnosis ◽

Self Administration ◽

Diagnosis And Management ◽

Life Threatening ◽

Short And Long Term

Hereditary angioedema is a rare genetic disorder caused by deficiency of C1 esterase inhibitor (C1-INH) and characterized by recurrent episodes of severe swelling that affect the limbs, face, intestinal tract and airway. Since laryngeal oedema can be life-threatening as a result of asphyxiation, correct diagnosis and management of hereditary angioedema is vital. Hereditary angioedema attacks are mediated by bradykinin, the production of which is regulated by C1-INH. Hereditary angioedema therapy relies on treatment of acute attacks, and short- and long-term prophylaxis. Acute treatment options include C1-INH concentrate, icatibant and ecallantide. Self-administration of treatment is recommended and is associated with increased quality of life of patients with hereditary angioedema. Advances in diagnosis and management have improved the outcomes and quality of life of patients with hereditary angioedema.

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Infratentorial subdural empyemas mimicking pyogenic meningitis

Journal of Neurosciences in Rural Practice ◽

10.4103/0976-3147.112773 ◽

2013 ◽

Vol 04 (02) ◽

pp. 213-215 ◽

Cited By ~ 1

Author(s):

Anurag Gupta ◽

Suman S Karanth ◽

A Raja

Keyword(s):

Surgical Intervention ◽

Treatment Options ◽

Rare Condition ◽

Pyogenic Meningitis ◽

Suppurative Otitis Media ◽

Life Threatening ◽

History Of ◽

Associated Risk Factors ◽

High Degree ◽

Delay In Treatment

ABSTRACTInfratentorial subdural empyema is an extremely rare condition which unfortunately mimics pyogenic meningitis in 75% of cases. While an ill‑planned lumbar puncture in these cases may be fatal, an inadvertent delay in treatment may be detrimental to the outcome for the patient. We present a case of a young boy with long standing history of chronic suppurative otitis media (CSOM) presenting with an infratentorial empyema with features suggestive of pyogenic meningitis. We also review the available literature to further define the condition in terms of clinical features, treatment options, and outcome. A misdiagnosis of this condition with failure to institute appropriate surgical intervention and antibiotic therapy is potentially life threatening. We highlight this rare condition which requires a high degree of suspicion especially in the presence of associated risk factors.

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Life-threatening Capillary Leak Syndrome in an Adult with Refractory Acute Myeloid Leukemia during Allogeneic Transplantation: a Case Report and Review of Literature

Journal of Transplantation Technologies & Research ◽

10.4172/2161-0991.1000s4-003 ◽

2018 ◽

Vol 08 (01) ◽

Cited By ~ 1

Author(s):

Yi-Zhi J ◽

Lai-Quan H ◽

Gui-Ping S ◽

Yan D ◽

He-Sheng H ◽

...

Keyword(s):

Acute Myeloid Leukemia ◽

Case Report ◽

Myeloid Leukemia ◽

Allogeneic Transplantation ◽

Capillary Leak Syndrome ◽

Capillary Leak ◽

Review Of Literature ◽

Life Threatening ◽

Refractory Acute Myeloid Leukemia ◽

Acute Myeloid

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New-Onset Systemic Capillary Leak Syndrome in an Adult Patient with COVID-19

Case Reports in Critical Care ◽

10.1155/2021/8098942 ◽

2021 ◽

Vol 2021 ◽

pp. 1-3

Author(s):

Daniel B. Knox ◽

Vivian Lee ◽

Lindsay Leither ◽

Samuel M. Brown

Keyword(s):

Adult Patient ◽

Therapeutic Approach ◽

Disease Process ◽

Underlying Disease ◽

Capillary Leak Syndrome ◽

Cytokine Storm ◽

Capillary Leak ◽

Systemic Capillary Leak Syndrome ◽

Laboratory Findings ◽

New Onset

Systemic capillary leak syndrome (SCLS) is a rare disorder manifesting as shock, hemoconcentration, and hypoalbuminemia, which may be either idiopathic or secondary to an underlying disease process. We report a case of an adult with COVID-19 infection associated with new onset SCLS. Our case joins only two other cases of new SCLS associated with COVID-19 infection reported in the literature. The clinical and laboratory findings in this case are distinct from findings seen in COVID-19 cytokine storm syndrome. Whether our therapeutic approach was efficacious is unknown. Further research into causes and therapies for these syndromes is urgently indicated.

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Capillary leak syndrome and disseminated intravascular coagulation after kidney transplantation in a patient with hereditary angioedema - A case report -

Anesthesia and Pain Medicine ◽

10.17085/apm.20098 ◽

2021 ◽

Vol 16 (1) ◽

pp. 75-80

Author(s):

Jeong Wook Park ◽

Jinyoung Seo ◽

Sang Hun Kim ◽

Ki Tae Jung

Keyword(s):

Kidney Transplantation ◽

Disseminated Intravascular Coagulation ◽

Hereditary Angioedema ◽

Treatment Options ◽

Deceased Donor ◽

Fresh Frozen Plasma ◽

Capillary Leak Syndrome ◽

Capillary Leak ◽

Intravascular Coagulation ◽

Fresh Frozen

Background: Hereditary angioedema (HAE) is a rare disease caused by the deficiency of C1 esterase inhibitor. HAE has a risk of life-threatening complications such as capillary leak syndrome (CLS) and disseminated intravascular coagulation (DIC).Case: A 42-year-old man with HAE presented for deceased-donor kidney transplantation. Prophylactic fresh frozen plasma (FFP) was given before surgery because of the risk of edema development. With careful management during anesthesia, there were no problems during surgery. However, generalized edema, hypotension, hypoalbuminemia, massive drainage of serosanguineous fluids from the intraabdominal space, and DIC occurred on the day after surgery. CLS was suspected and sustained hypotension with generalized edema became worse despite treatment with albumin, danazol, FFP, and vasoactive drugs. The patient’s condition worsened despite intensive care and he died due to shock.Conclusions: The anesthesiologist should prepare for the critical complications of HAE and prepare the appropriate treatment options.

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