title: Gemcitabine-induced systemic capillary leak syndrome.
abstract: Systemic capillary leak syndrome (SCLS) is a rare disorder with a high mortality rate, characterized by rapidly developing edema, weight gain and hypotension, hemoconcentration and hypoproteinemia. This syndrome is caused by sudden, reversible capillary hyperpermeability with a rapid extravasation of plasma from the intravascular to the interstitial space. Even though SCLS has been suggested to be the pathogenic mechanism for the pulmonary toxicity of gemcitabine (GCB), a new deoxycytidine analogue with structural similarities to cytosine arabinoside, a direct correlation between GCB and SCLS has never been reported. We describe a case of repeated SCLS after GCB administration in a 51-year-old male with locally-advanced non-small-cell lung cancer treated with a combination of cisplatin and GCB. The detection of GCB-induced SCLS supports the hypothesis that SCLS could be the pathogenic way of GCB pulmonary toxicity. This finding can help to better understand and treat the potentially deadly GCB-related acute respiratory distress syndrome that is being recognized.
authors.affiliation: Division of Medical Oncology,European Institute of Oncology, Milano, Italy. tommaso.de-pas@ieo.it
authors.forename: T
authors.initials: T
authors.lastname: De Pas
authors.forename: G
authors.initials: G
authors.lastname: Curigliano
authors.forename: L
authors.initials: L
authors.lastname: Franceschelli
authors.forename: C
authors.initials: C
authors.lastname: Catania
authors.forename: L
authors.initials: L
authors.lastname: Spaggiari
authors.forename: F
authors.initials: F
authors.lastname: de Braud
mesh_terms: D000964:Antimetabolites, Antineoplastic / Q000009:adverse effects* / Q000627:therapeutic use; D019559:Capillary Leak Syndrome / Q000139:chemically induced*; D002289:Carcinoma, Non-Small-Cell Lung / Q000188:drug therapy; D002945:Cisplatin / Q000627:therapeutic use; D003841:Deoxycytidine / Q000009:adverse effects* / Q000031:analogs & derivatives* / Q000627:therapeutic use; D006801:Humans; D008175:Lung Neoplasms / Q000188:drug therapy; D008297:Male; D008875:Middle Aged; D000093542:Gemcitabine
chemical_list: D000964:Antimetabolites, Antineoplastic; D003841:Deoxycytidine; D002945:Cisplatin; D000093542:Gemcitabine