Two cases of systemic capillary leak syndrome that were treated with pentastarch.
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.
Lee
Young Seok
YS
Department of Internal Medicine, College of Medicine, Hallym University, Chuncheon, Korea.
Kim
Sun Young
SY
Kwon
Chin Woo
CW
Song
Hae Geun
HG
Lee
Young Kyung
YK
Kim
Hyo Jung
HJ
Zang
Dae Young
DY
D000328:Adult; D019559:Capillary Leak Syndrome / Q000175:diagnosis / Q000188:drug therapy* / Q000209:etiology; D002199:Capillary Permeability; D005260:Female; D006801:Humans; D006895:Hydroxyethyl Starch Derivatives / Q000627:therapeutic use*; D010952:Plasma Substitutes / Q000627:therapeutic use*
D006895:Hydroxyethyl Starch Derivatives; D010952:Plasma Substitutes