TY - JOUR
T1 - 10-year-old girl with life-threatening idiopathic systemic capillary leak syndrome
T2 - A case report
AU - Iwasa, Tadashi
AU - Ohashi, Hiroyuki
AU - Kihira, Kentaro
AU - Koike, Yuhki
AU - Otake, Kohei
AU - Inoue, Mikihiro
AU - Sawada, Hirofumi
AU - Toyoda, Hidemi
AU - Komada, Yoshihiro
PY - 2014/5/31
Y1 - 2014/5/31
N2 - Background: Idiopathic systemic capillary leak syndrome (ISCLS) is a rare disorder, characterized by episodic life-threatening hypotension, hypoalbuminemia, and hemoconcentration.Case presentation: A 10-year-old girl presented with abdominal pain, vomiting, diarrhea, fever and developed generalized edema a day after admission. Clinical and laboratory findings were consistent with ISCLS. She received aggressive fluid replacement, methylprednisolone pulse (30 mg/kg/day), high-dose intravenous immunoglobulin (IVIG, 2 g/kg/day) and plasma exchange in acute phase. She received fasciotomy of bilateral lower extremities as she developed complications of compartment syndrome. Since there were two episodes of ISCLS attacks, theophylline and terbutaline were initiated for prevention of attacks and then the remission is currently maintained. Because of high fatality rate in ISCLS, prompt diagnosis and intervention are very important.Conclusion: We describe here, a rare case of pediatric ISCLS. ISCLS should be considered as a differential diagnosis, when the patient presents with unexplained or sudden hypovolemic shock. Reports on pediatrics ISCLS are very few, and accumulation of similar case reports is needed.
AB - Background: Idiopathic systemic capillary leak syndrome (ISCLS) is a rare disorder, characterized by episodic life-threatening hypotension, hypoalbuminemia, and hemoconcentration.Case presentation: A 10-year-old girl presented with abdominal pain, vomiting, diarrhea, fever and developed generalized edema a day after admission. Clinical and laboratory findings were consistent with ISCLS. She received aggressive fluid replacement, methylprednisolone pulse (30 mg/kg/day), high-dose intravenous immunoglobulin (IVIG, 2 g/kg/day) and plasma exchange in acute phase. She received fasciotomy of bilateral lower extremities as she developed complications of compartment syndrome. Since there were two episodes of ISCLS attacks, theophylline and terbutaline were initiated for prevention of attacks and then the remission is currently maintained. Because of high fatality rate in ISCLS, prompt diagnosis and intervention are very important.Conclusion: We describe here, a rare case of pediatric ISCLS. ISCLS should be considered as a differential diagnosis, when the patient presents with unexplained or sudden hypovolemic shock. Reports on pediatrics ISCLS are very few, and accumulation of similar case reports is needed.
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U2 - 10.1186/1471-2431-14-137
DO - 10.1186/1471-2431-14-137
M3 - Article
C2 - 24885961
AN - SCOPUS:84902358677
SN - 1471-2431
VL - 14
JO - BMC Pediatrics
JF - BMC Pediatrics
IS - 1
M1 - 137
ER -