[A rare cause of muscle pain and elevated creatine kinase level--the paroxysmal non-hereditary angioedema].
Systemic capillary leak syndrome is a rare idiopathic disorder characterized by recurrent episodes of hypotension and hemoconcentration due to sudden transient extravasation of up to 70% of plasma. Less than 40 cases have appeared in the literature. Mortality rates 5 years after diagnosis have been reported to be up to 75%. Clinical findings are generalized edema and intravasal fluid deficiency. Laboratory features include hypoalbuminemia and extreme hemoconcentration. A common finding is a monoclonal gammopathy. Rare manifestation of this syndrome is rhabdomyolysis due to increased compartment pressure and ischemic myonecrosis. Early diagnosis and exclusion of other clinical disorders like rheumatic myopathies and myositis are critical concerning prognosis and therapy. We describe a 46-year-old woman with rhabdomyolysis and systemic capillary leak syndrome whose condition is stable for a total of 30 months under a prophylactic regimen with oral terbutaline plus theophylline. A brief survey of the literature is given.
Rheumazentrum Düsseldorf Heinrich-Heine-Universität.
R
R
Fischer
A
A
Peters
M
M
Klein
M
M
Leschke
M
M
Schneider
D000318:Adrenergic beta-Agonists / Q000008:administration & dosage; D000799:Angioedema / Q000175:diagnosis* / Q000188:drug therapy; D019559:Capillary Leak Syndrome / Q000175:diagnosis* / Q000188:drug therapy; D003402:Creatine Kinase / Q000097:blood*; D004359:Drug Therapy, Combination; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008875:Middle Aged; D009135:Muscular Diseases / Q000209:etiology*; D010146:Pain / Q000209:etiology*; D012206:Rhabdomyolysis / Q000175:diagnosis / Q000188:drug therapy; D013726:Terbutaline / Q000008:administration & dosage; D013806:Theophylline / Q000008:administration & dosage
D000318:Adrenergic beta-Agonists; D013806:Theophylline; D003402:Creatine Kinase; D013726:Terbutaline