title: [Shock, hemoconcentration, and generalized edema in a 47-year-old man].
abstract: We report the case of a 47-year-old man who was admitted because of syncope. Upon hospital admission, he rapidly developed circulatory shock with generalized edema and a severe hemoconcentration with a hematocrit of 70%. The condition was stabilized with infusion of 17 l of cristalloid fluids over a period of 24 h. After ruling out possible secondary causes, the diagnosis of a systemic capillary leak syndrome--a severe transient endothelial barrier dysfunction of unknown origin--was made. A triad of hypotension, hemoconcentration (hematocrit  >60%) and macromolecular extravasation is the typical finding; furthermore, a strong association with monoclonal gammopathy of unknown significance (MGUS) is described.
authors.affiliation: Klinik und Poliklinik für Innere Medizin III, Universitätsklinikum Halle (Saale), Martin-Luther-Universität Halle-Wittenberg, Ernst-Grube-Straße 40, Halle (Saale), Germany.
authors.forename: T
authors.initials: T
authors.lastname: Rahn
authors.forename: A
authors.initials: A
authors.lastname: Plehn
authors.forename: H
authors.initials: H
authors.lastname: Lemm
authors.forename: S
authors.initials: S
authors.lastname: Abromeit
authors.forename: S
authors.initials: S
authors.lastname: Dambeck
authors.forename: F
authors.initials: F
authors.lastname: Busanny
authors.forename: L
authors.initials: L
authors.lastname: Neumann
authors.forename: K
authors.initials: K
authors.lastname: Werdan
authors.forename: H
authors.initials: H
authors.lastname: Ebelt
mesh_terms: D019559:Capillary Leak Syndrome / Q000175:diagnosis* / Q000628:therapy*; D003937:Diagnosis, Differential; D004487:Edema / Q000175:diagnosis* / Q000628:therapy*; D006801:Humans; D008297:Male; D008875:Middle Aged; D012769:Shock / Q000175:diagnosis* / Q000628:therapy*; D016896:Treatment Outcome