Trastuzumab-Induced Systemic Capillary Leak Syndrome in a Breast Cancer Patient

Abstract

Systemic capillary leak syndrome (SCLS) is a rare health condition. It is characterized by recurrent episodes of generalized edema and severe hypotension along with hypoproteinemia. The condition is under recognized because of its nonspecific signs and symptoms, and high mortality rate. SCLS triggered by trastuzumab, a target drug for Her2-positive breast cancer patients, has not been previously reported. A 59-year-old Chinese woman, diagnosed with breast cancer with accompanying liver and bone metastasis, was treated with 3 cycles of docetaxel with capecitabine and a regimen of 12 cycles of capecitabine with trastuzumab. The patient developed systemic capillary leak syndrome during the 16th cycle of chemotherapy. Post-diagnosis treatment regimen is also presented in the current case report. SCLS has been previously observed in breast cancer patients. However, SCLS incidence post-chemotherapeutic treatment with trastuzumab has not been reported elsewhere. Hence, our report highlights the need for rigorous investigation of the side effects of trastuzumab usage and the increasing need of insightful diagnosis to manage any incidence of SCLS. The case provides valuable experience for treating the uncommon adverse effects of trastuzumab in Her2-positive breast cancer patients.

Systemic capillary leak syndrome in a patient receiving adjuvant oxaliplatin for locally advanced colon cancer

“…SCLS has been associated with medical conditions such as sepsis and acute renal failure, as well as medications such as gemcitabine and trastuzumab. 4 Here, we report a case of oxaliplatin-induced capillary-leak syndrome in a 63-year-old man undergoing his final cycle of FOLFOX.…”

Syndrome de fuite capillaire idiopathique et formes secondaires : une revue systématique de la littérature

“…Cinq cas de SFCS à la clofarabine ont été décrits dans le traitement des leucémies lymphoblastiques [82,83]. Enfin, un cas de SFCS au trastuzumab a été publié chez une patiente chinoise traitée pour un cancer du sein, apparaissant au 16 e cycle de traitement [84].…”

Systemic capillary leak syndrome following granulocyte colony-stimulating factor therapy in a T-lymphoblastic leukemia/lymphoma patient: a case report

“…The pathophysiological mechanism leading to SCLS is poorly studied but hypothesized to be a state of endothelial dysfunction and hypercytokinemia [ 3 ]. A considerable number of case reports have elucidated that SCLS can be precipitated by certain medications including vincristine [ 4 ], gemcitabine [ 5 ], rituximab [ 6 ], trastuzumab [ 7 ], acitretin [ 8 ], clofarabine [ 9 ], interleukin‑2 [ 10 ], interleukin-11 [ 11 ], and (G-CSF) [ 12 ]. The latter being the core of our article as we report a case of G‑CSF-induced SCLS in a 21-year-old patient diagnosed with T‑lymphoblastic leukemia/lymphoma.…”

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