Korean J Intern Med.  2007 Jun;22(2):130-132. 10.3904/kjim.2007.22.2.130.

Two Cases of Systemic Capillary Leak Syndrome that were Treated with Pentastarch

• Lee YS
• Kim SY
• Kwon CW
• Song HG
• Lee YK
• Kim HJ
• Zang DY

• KMID: 1091876
• DOI: http://doi.org/10.3904/kjim.2007.22.2.130

Abstract

Systemic capillary leak syndrome (SCLS) is a condition that's caused by the shift of fluid and protein from the intravascular space to the interstitial space as a result of repetitive episodes of capillary hyperpermeability. The pathogenesis of SCLS is still unclear, but there's recently been a report showing this syndrome in association with monoclonal gammopathy. This syndrome can be a fatal disease because cardiovascular collapse can occur in the initial capillary leak phase. Although theophylline, diuretics, terbutaline, steroids, calcium antagonist, Ginkgo biloba extracts and plasmapheresis have been suggested as medication, none of them have been proven to be effective. Considering that this disease is self-limiting, conservative treatment in the acute phase is believed to be very important. Because hypoalbuminemia is very a common manifestation of SCLS, Pentastarch, which has a higher molecular weight than albumin, could be efficient to prevent cardiovascular collapse. We used 10% Pentastarch during the acute SCLS attacks of 2 patients and the patients both showed a dramatic response. Pentastarch may be helpful to treat SCLS in its initial capillary leak phase by the elevating blood pressure, and this might contribute to somewhat decreasing the acute mortality of SCLS.

Keyword

Systemic capillary leak syndrome; Pentastarch; Cardiovascular collapse

MeSH Terms

Adult
Capillary Leak Syndrome/diagnosis/*drug therapy/etiology
Capillary Permeability
Female
Hetastarch/*therapeutic use
Humans
Plasma Substitutes/*therapeutic use