Acute renal failure associated with systemic capillary leak syndrome |
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Authors: | K Fukunari M Nishimura F Taguchi A Yamada S Okamatsu |
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Institution: | (1) Department of Nephrology, Iizuka Hospital, 3-83 Yoshio-cho, Iizuka City, Fukuoka 820-8505, Japan Tel. +81-948-22-3800; Fax +81-948-29-8747 e-mail: fukunari-k01@aso-group.co.jp, JP;(2) Department of Hematology, Iizuka Hospital, Iizuka, Japan, JP;(3) Department of Cardiology, Iizuka Hospital, Iizuka, Japan, JP |
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Abstract: | Systemic capillary leak syndrome (SCLS) is rare disorder characterized by unexplained episodic capillary hy-perpermeability,
resulting in generalized edema and hypovolemic shock. During acute episodes, there is characteristic elevated hematocrit and
reduced serum protein. We report a 55-year-old man who had two recurrent episodes of SCLS. Laboratory findings revealed severe
hypoalbuminemia, sudden elevation of hematocrit, and paraprotein IgG κ chain in his serum. The patient had acute oliguric
renal failure during the acute episode. Despite receiving a large amount of fluid resuscitation, his hematocrit rose to 71.4%.
After combination therapy of venesection and fluid resuscitation, massive diuresis occurred, and the symptoms were alleviated.
We found that venesection was effective in controlling the acute episode of SCLS, without troublesome adverse effects. Although
prophylactic therapy with terbutaline and theophylline is effective for SCLS, treatment in the acute phase is still empirical.
We conclude that fluid replacement therapy accompanied by venesection is an alternative regimen in patients with severe capillary
leakage.
Received: August 23, 1999 / Accepted: March 29, 2000 |
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Keywords: | Systemic capillary leak syndrome Acute renal failure Venesection |
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