[Hypotension and Generalized Edema Due to Plasma Leakage: A Case Report]

Generalized edema is commonly encountered in everyday clinical practice, usually due to heart, liver and renal disease. On the other hand, edema related to fluid extravasation associated with hypotension, hemoconcentration and hypalbuminemia is a rare clinical disorder. We present a case of a 61-year-old man with 3 subsequent endothelium permeability alteration episodes with increasing severity related to Sars-Cov-2 infection. During the last episode he was admitted to the intensive care unit, a monoclonal gammopathy was diagnosed and acute kidney injury requiring continuous renal replacement therapy developed. Systemic capillary leak syndrome or Cklarkson's disease was diagnosed, and the three phases of the condition were recognized, i.e. the prodromal phase, the acute shock phase and the recovery phase. The patients recovered and his kidney function returned to normal values. Nephrologists should be aware of plasma leakage syndromes being their management, especially fluid infusion, difficult due to the risk of complications such as acute kidney injury, compartment syndrome and neuropathy, rhabdomyolysis, myocardial edema, pericardial-pleural-abdominal effusion, deep vein thrombosis and acute pulmonary edema. Sars-Cov-2 infection appears to have increased the frequency of this rare disease.