Clinical Presentation, Management, and Prognostic Factors of Idiopathic Systemic Capillary Leak Syndrome

A Systematic Review

Tae Seong Eo, Kyung Ju Chun, Su Jung Hong, Ji Young Kim, I. Re Lee, Keum Hwa Lee, Michael Eisenhut, Andreas Kronbichler, Jaeil Shin

Research output: Contribution to journalArticle

12 Citations (Scopus)

Abstract

Background: The idiopathic systemic capillary leak syndrome is a rare disease characterized by unexplained recurrent shock caused by capillary hyperpermeability. Because of the rarity of the disease, this disease has easily been misdiagnosed and evidence of efficacious agents used empirically is lacking. Objective: To analyze the clinical and laboratory data, treatment modalities, and mortality rate of patients and to find contributing factors leading to mortality. Methods: We searched MEDLINE (inception to December 2016) and reviewed reference lists of previous systematic reviews. A total of 133 case reports (161 patients) and 5 case series (102 patients) of idiopathic systemic capillary leak syndrome were included. Results: Patients had hypotension (81.4%), edema (64.6%), and previous flu-like illness (34.2%). This disease was misdiagnosed as hypovolemic shock, septic shock, polycythemia vera, or angioedema. Thirty-seven patients died (23%) mainly because of systemic capillary leak syndrome itself (78.4%). There were significant differences in the survival rates between patients who were treated with prophylactic β2 agonists, methylxanthines, and intravenous immunoglobulins and those who were not. The estimated 1-, 5-, and 10-year survival rate of patients treated with intravenous immunoglobulins was 100%, 94%, and 94%, respectively. Conclusions: We systematically analyzed in detail clinical presentations of all reported patients and identified various factors associated with mortality and effects of prophylactic treatment in idiopathic systemic capillary leak syndrome. The findings of this review will facilitate diagnostic approaches of idiopathic systemic capillary leak syndrome and aid in the selection of treatment.

Original languageEnglish
Pages (from-to)609-618
Number of pages10
JournalJournal of Allergy and Clinical Immunology: In Practice
Volume6
Issue number2
DOIs
Publication statusPublished - 2018 Mar 1

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Capillary Leak Syndrome
Intravenous Immunoglobulins
Diagnostic Errors
Mortality
Shock
Survival Rate
Angioedema
Polycythemia Vera
Septic Shock
Rare Diseases
MEDLINE
Hypotension
Edema
Therapeutics

All Science Journal Classification (ASJC) codes

  • Immunology and Allergy

Cite this

Eo, Tae Seong ; Chun, Kyung Ju ; Hong, Su Jung ; Kim, Ji Young ; Lee, I. Re ; Lee, Keum Hwa ; Eisenhut, Michael ; Kronbichler, Andreas ; Shin, Jaeil. / Clinical Presentation, Management, and Prognostic Factors of Idiopathic Systemic Capillary Leak Syndrome : A Systematic Review. In: Journal of Allergy and Clinical Immunology: In Practice. 2018 ; Vol. 6, No. 2. pp. 609-618.
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Clinical Presentation, Management, and Prognostic Factors of Idiopathic Systemic Capillary Leak Syndrome : A Systematic Review. / Eo, Tae Seong; Chun, Kyung Ju; Hong, Su Jung; Kim, Ji Young; Lee, I. Re; Lee, Keum Hwa; Eisenhut, Michael; Kronbichler, Andreas; Shin, Jaeil.

In: Journal of Allergy and Clinical Immunology: In Practice, Vol. 6, No. 2, 01.03.2018, p. 609-618.

Research output: Contribution to journalArticle

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AU - Eo, Tae Seong

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AU - Lee, I. Re

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AU - Eisenhut, Michael

AU - Kronbichler, Andreas

AU - Shin, Jaeil

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N2 - Background: The idiopathic systemic capillary leak syndrome is a rare disease characterized by unexplained recurrent shock caused by capillary hyperpermeability. Because of the rarity of the disease, this disease has easily been misdiagnosed and evidence of efficacious agents used empirically is lacking. Objective: To analyze the clinical and laboratory data, treatment modalities, and mortality rate of patients and to find contributing factors leading to mortality. Methods: We searched MEDLINE (inception to December 2016) and reviewed reference lists of previous systematic reviews. A total of 133 case reports (161 patients) and 5 case series (102 patients) of idiopathic systemic capillary leak syndrome were included. Results: Patients had hypotension (81.4%), edema (64.6%), and previous flu-like illness (34.2%). This disease was misdiagnosed as hypovolemic shock, septic shock, polycythemia vera, or angioedema. Thirty-seven patients died (23%) mainly because of systemic capillary leak syndrome itself (78.4%). There were significant differences in the survival rates between patients who were treated with prophylactic β2 agonists, methylxanthines, and intravenous immunoglobulins and those who were not. The estimated 1-, 5-, and 10-year survival rate of patients treated with intravenous immunoglobulins was 100%, 94%, and 94%, respectively. Conclusions: We systematically analyzed in detail clinical presentations of all reported patients and identified various factors associated with mortality and effects of prophylactic treatment in idiopathic systemic capillary leak syndrome. The findings of this review will facilitate diagnostic approaches of idiopathic systemic capillary leak syndrome and aid in the selection of treatment.

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