Consider systemic capillary leak syndrome in monoclonal gammopathy with shock

Ounci-Essad,; Bouchlarhem, Amine; Lamzouri, Oussama; Aidouni, Ghizlane El; Haddar, Leila; Mimouni, Hamza; Bkiyar, Houssam; Housni, Brahim

doi:10.1016/j.amsu.2021.103013

Cited by 4 publications

(1 citation statement)

References 8 publications

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“…This observation raises the intriguing possibility that capillary leak associated with sorafenib could manifest in an atypical manner without hemodynamic instability. Severe hemodynamic compromise is frequently associated with pericardial effusion or cardiac tamponade that necessitates drainage with pressor support and rarely extracorporeal membrane oxygenation [9‒12], but neither was observed with our patient. Current candidate therapies for capillary leak syndrome, including intravenous immunoglobulins, steroids, terbutaline, theophylline, and biologics [13], were not needed inpatient given her rapid improvement on conservative measures.…”

Section: Discussionmentioning

confidence: 67%

Sorafenib-Induced Capillary Leak Syndrome

Kwon,

Odackal,

Husain

et al. 2023

Case Rep Oncol

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Capillary leak syndrome is a rare life-threatening disorder of acute endothelial hyperpermeability. It consists of initial fluid extravasation resulting in hypotension, hypoalbuminemia, and hemoconcentration, followed by noncardiogenic pulmonary edema from rapid fluid remobilization into intravascular compartment. Drug-induced etiology is an important diagnostic consideration in cancer patients, particularly with use of antimetabolites, immunostimulants, and monoclonal antibodies. Sorafenib-mediated capillary leak syndrome has never been reported. Here, we present the case of a 29-year-old female patient with a desmoid tumor of the thigh, who was admitted for acute hypoxic respiratory failure after recent initiation of sorafenib. She was found to have extensive pulmonary edema, bilateral pleural effusions, and hemoconcentration, all of which stabilized on supportive care with noninvasive mechanical ventilation and intravenous diuresis. Her infectious and cardiac work-up were negative. Given the temporal relationship between sorafenib use and symptom onset as well as a lack of an alternative etiology of her findings, patient was deemed to have sorafenib-induced acute capillary leak syndrome. Importantly, she did not become hypotensive prior to or during this hospitalization. To our knowledge, we reported for the first time an atypical presentation of acute capillary leak syndrome due to sorafenib use without hemodynamic instability.

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Section: Discussionmentioning

confidence: 67%