[Recurrent unexplained lipothymia: do not forget the capillary leak syndrome].
BACKGROUND
Systemic capillary leak syndrome (SCLS) is a rare disorder characterized by recurrent spontaneous episodes of hypovolaemic shock due to marked plasma shifts from the intravascular to the extravascular space. It presents as the characteristic triad of hypotension, haemoconcentration and hypoalbuminemia.


METHODS
We describe a patient with SCLS with recurrent lipothymia who presented first with delayed oedema that was thought to be due to orlistat treatment. On the second episode the patient was seen with a pulmonary hypertension when plasma came back into vessels. On the third time the characteristic triad led to the diagnosis of SCLS.


CONCLUSIONS
SCLS should be considered in the differential diagnosis of recurrent hypovolemic shock without identifiable cause. Nevertheless, symptoms may be restricted to sole lipothymia or transient oedema or delayed hypoalbuminemia rendering the diagnosis difficult.
Debourdeau
P
P
Service de médecine interne, hôpital Desgenettes, 108 boulevard Pinel, 69003 Lyon, France. pdebourdeau@yahoo.fr
Bory
P
P
Zammit
C
C
Pavic
M
M
Colle
B
B
D019559:Capillary Leak Syndrome / Q000175:diagnosis*; D003937:Diagnosis, Differential; D006400:Hematocrit; D006801:Humans; D034141:Hypoalbuminemia / Q000175:diagnosis; D007024:Hypotension, Orthostatic / Q000175:diagnosis; D008297:Male; D012769:Shock / Q000175:diagnosis; D013575:Syncope / Q000175:diagnosis