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[Recurrent unexplained lipothymia: do not forget the capillary leak syndrome]
P Debourdeau1, P Bory, C Zammit
1Service de médecine interne, hôpital Desgenettes, 108 boulevard Pinel, 69003 Lyon, France. pdebourdeau@yahoo.fr
La Revue De Medecine Interne
|February 27, 2007
Summary
Systemic capillary leak syndrome (SCLS) is a rare disorder causing recurrent hypovolemic shock. Early diagnosis is crucial, as symptoms like edema or lipothymia can mask this condition.
Area of Science:
- Internal Medicine
- Rare Diseases
- Vascular Biology
Background:
- Systemic capillary leak syndrome (SCLS) is a rare disorder characterized by recurrent spontaneous episodes of hypovolemic shock.
- It involves marked plasma shifts from the intravascular to the extravascular space, presenting with hypotension, hemoconcentration, and hypoalbuminemia.
Observation:
- A case of SCLS with recurrent lipothymia is presented, initially misdiagnosed as orlistat-induced edema.
- Subsequent episodes revealed pulmonary hypertension during plasma return and finally the characteristic triad leading to SCLS diagnosis.
Findings:
- SCLS diagnosis can be challenging due to atypical presentations.
- Symptoms may include isolated lipothymia, transient edema, or delayed hypoalbuminemia, complicating early identification.
Implications:
- SCLS should be considered in the differential diagnosis of recurrent hypovolemic shock of unknown origin.
- Increased awareness of varied SCLS presentations is vital for timely diagnosis and management.
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