Benzekri H, Bouchlarhem A, lamassab NEH, Jabri M, Jabrouni F, Daoudi C, Oulali N. Capillary hyperpermeability syndrome: A fatal complication of acute leukaemia: Case report and review.
Ann Med Surg (Lond) 2022;
75:103336. [PMID:
35242315 PMCID:
PMC8881642 DOI:
10.1016/j.amsu.2022.103336]
[Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2021] [Revised: 01/27/2022] [Accepted: 02/01/2022] [Indexed: 12/01/2022] Open
Abstract
Introduction
The capillary hyperpermeability syndrome is a rare disease that should be suspected in the presence of recurrent generalized edema without obvious cause, which may be idiopathic or secondary.
Case presentation
In this case, we report a Clarkson syndrome secondary to an acute leukemia affecting a 4-year-old child admitted to the emergency room in respiratory and hemodynamic distress with a generalized oedematous syndrome and a bone marrow failure syndrome. Laboratory tests concluded that the patient was suffering from an acute lymphoblastic leukemia, hypoalbuminemia, pericardial effusion, and the absence of any other cause that is in favor of a capillary leak syndrome.In spite of the filling and the introduction of drugs, the cardio respiratory arrest could not be recovered and the child died 24h after his admission.
Discussion
It is a rare pathology described for the first time in 1960, generally secondary to a pathological state and more rarely idiopathic, to be evoked in front of clinical and biological parameters which are hypoalbuminemia, hemiconcentration and hypoperfusion, after having eliminated a sepsis in the first place.The treatment is based on the management of the acute phase by filling with crystalloids, drugs or even steroids, and as a preventive treatment of relapses immunoglobulins or theophylline are used.
Conclusion
The evolution can be quickly fatal, that's why it is necessary to know how to evoke this syndrome in front of a similar clinical presentation.
Capillary hyperpermeability syndrome is a rare cause of generalized edema.
The diagnosis is made on the basis of hypoalbuminemia, hemoconcentration, and hypoperfusion.
A monoclonal gammopathy type igG is rarely found in children unlike in adults.
Relapse prevention remains a very important part of treatment with immunoglobulin, theophylline or anti TNF alpha.
Collapse