A new diagnosis of systemic capillary leak syndrome in a patient with COVID-19

Lacout, Carole; Rogez, Juliette; Orvain, Corentin; Nicot, Claire; Rony, Louis; H, Julien; Urbanski, G.

doi:10.1093/rheumatology/keaa606

Cited by 27 publications

(30 citation statements)

References 7 publications

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“…Information from our studies complements the findings of several recent case reports of severe SCLS attacks associated with mild-to-moderate SARS-CoV-2 infection ( 9 – 12 ). In each of the cases in those studies, patients exhibited all the hallmarks of severe SCLS exacerbations after experiencing mild-to-moderate symptoms of COVID-19; 2 of 3 patients died from SCLS-related complications.…”

Section: Discussionsupporting

confidence: 82%

“…These results suggest that the cytokine storm associated with mild-to-moderate COVID-19 may lead to an SCLS flare. Alternatively, as suggested elsewhere ( 9 ), it is also possible that SARS-CoV-2 may be directly toxic to endothelial cells. This hypothesis suggests that viral factors synergize with host-intrinsic mechanisms to provoke severe SCLS flares.…”

Section: Discussionmentioning

confidence: 83%

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Fatal Exacerbations of Systemic Capillary Leak Syndrome Complicating Coronavirus Disease

Cheung¹,

Eisch²,

Maleque³

et al. 2021

Emerg. Infect. Dis.

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We report 2 fatal exacerbations of systemic capillary leak syndrome (SCLS), also known as Clarkson disease, associated with coronavirus disease (COVID-19) in the United States. One patient carried an established diagnosis of SCLS and the other sought treatment for new-onset hypotensive shock, hemoconcentration, and anasarca, classic symptoms indicative of an SCLS flare. Both patients had only mild-to-moderate symptoms of COVID-19. This clinical picture suggests that these patients succumbed to complications of SCLS induced by infection with severe acute respiratory syndrome coronavirus 2. Persons with known or suspected SCLS may be at increased risk for developing a disease flare in the setting of mild-to-moderate COVID-19 infection.

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Section: Discussionsupporting

confidence: 82%

Section: Discussionmentioning

confidence: 83%

Fatal Exacerbations of Systemic Capillary Leak Syndrome Complicating Coronavirus Disease

Cheung¹,

Eisch²,

Maleque³

et al. 2021

Emerg. Infect. Dis.

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show abstract

“…This case demonstrates salient clinical features seen in SCLS including refractory shock, multiple organ failure, hemoconcentration, pericardial effusion, and venous thromboses. To date, there are only two other reports of new onset SCLS associated with COVID-19 [ 13 , 14 ]. Of the two reported, only one has survived to date [ 14 ].…”

Section: Introductionmentioning

confidence: 99%

“…To date, there are only two other reports of new onset SCLS associated with COVID-19 [ 13 , 14 ]. Of the two reported, only one has survived to date [ 14 ]. The case described here adds to the existing body of knowledge surrounding COVID-19-associated SCLS and the range of therapies administered.…”

Section: Introductionmentioning

confidence: 99%

“…The case described here adds to the existing body of knowledge surrounding COVID-19-associated SCLS and the range of therapies administered. There are three different etiologies of COVID-19-associated SCLS in the literature to date: (1) new onset [ 13 , 14 ], (2) exacerbations of preexisting SCLS (de [ 15 ]), and (3) vaccine-induced SCLS [ 16 , 17 ].…”

Section: Introductionmentioning

confidence: 99%

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New-Onset Systemic Capillary Leak Syndrome in an Adult Patient with COVID-19

Knox

Lee

Leither

et al. 2021

Case Reports in Critical Care

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Systemic capillary leak syndrome (SCLS) is a rare disorder manifesting as shock, hemoconcentration, and hypoalbuminemia, which may be either idiopathic or secondary to an underlying disease process. We report a case of an adult with COVID-19 infection associated with new onset SCLS. Our case joins only two other cases of new SCLS associated with COVID-19 infection reported in the literature. The clinical and laboratory findings in this case are distinct from findings seen in COVID-19 cytokine storm syndrome. Whether our therapeutic approach was efficacious is unknown. Further research into causes and therapies for these syndromes is urgently indicated.

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Jerne's “immune network theory”, of interacting anti‐idiotypic antibodies applied to immune responses during COVID‐19 infection and after COVID‐19 vaccination

Kurbel

2023

BioEssays

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Niels Kaj Jerne has proposed the “immune network theory” of interactions among anti‐idiotypic antibodies, able to interfere with humoral responses to certain antigens. After the occurrence of the primary generation of antibodies, against an antigenic epitope, idiotypes of these antibodies induce anti‐idiotypic antibodies that modulate the intensity of the first response, and so on. Adverse effects following SARS‐COV‐2 COVID‐19 vaccines are occasionally similar to the symptoms of COVID‐19 infection. Rare events linked to SARS‐CoV‐2 vaccines also resemble some rarely reported COVID‐19 complications. Safety data from product information by European Medicines Agency suggest that spectra do overlap for four main vaccines. The proposition is that vaccine events and COVID‐19 complications are related to anti‐idiotypic antibodies whose spatial shape can lead to interactions with ACE2 molecules, in individuals with a prolonged Spike protein synthesis. The vaccines target cells by their affinity to the vaccine vector, or to engulf lipid nanoparticles. Anti‐idiotypic antibodies shaped similarly to the Spike protein possibly interact with ACE2 molecules and cause diverse signs and symptoms.

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A new diagnosis of systemic capillary leak syndrome in a patient with COVID-19

Cited by 27 publications

References 7 publications

Fatal Exacerbations of Systemic Capillary Leak Syndrome Complicating Coronavirus Disease

Fatal Exacerbations of Systemic Capillary Leak Syndrome Complicating Coronavirus Disease

New-Onset Systemic Capillary Leak Syndrome in an Adult Patient with COVID-19

Jerne's “immune network theory”, of interacting anti‐idiotypic antibodies applied to immune responses during COVID‐19 infection and after COVID‐19 vaccination

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