Capillary leak syndrome laboratory findings
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-In-Chief: M. Hassan, M.B.B.S
Overview
All patients with capillary leak syndrome have an elevated hematocrit concentration during an attack, resulting in hemoconcentration. Moreover, elevated WBCs, elevated BUN, elevated creatinine, elevated creatine kinase and hypoalbuminemia without albuminuria may also be seen.
Laboratory Findings
Capillary leak syndrome presents with the following lab abnormalities:
- Hemoconcentration (Increased hemoglobin and hematocrit)
- Elevated WBCs
- Elevated Blood urea nitrogen (BUN)
- Elevated creatinine
- Elevated creatine kinase
- Hypoalbuminemia without albuminuria[1][2]
- Blood and urine cultures to rule out sepsis
- Serum tryptase to rule out anaphylaxis
- Serum immunofixation electrophoresis to determine the presence of paraprotein
- IgG kappa supports the diagnosis of systemic capillary leak syndrome[3]
The degree and duration of hypotension and edema may vary in patients with systemic capillary leak syndrome, and therefore, the severity scale may aid in the diagnosis of patients with recurrent episodes of swelling.
| Grade | Hemoconcentration | Hypoalbuminemia | Treatment |
|---|---|---|---|
| 1a | Hgb ≤ 3 g/dL | Albumin ≤ 0.5 g/dL | Oral fluids |
| 1b | Hgb ≥ 3 g/dL | Albumin ≥ 0.5 g/dL | Oral fluids |
| 2 | IV fluids, no hospitalization | ||
| 3 | IV fluids, ICU | ||
| 4 | ICU |
References
- ↑ Yardimci B, Kazancioglu R (2016). "Idiopathic Systemic Capillary Leak Syndrome: A Case Report". Iran Red Crescent Med J. 18 (2): e29249. doi:10.5812/ircmj.29249. PMC 4867362. PMID 27195144.
- ↑ Zancanaro A, Serafini F, Fantin G, Murer B, Cicardi M, Bonanni L; et al. (2015). "Clinical and pathological findings of a fatal systemic capillary leak syndrome (Clarkson disease): a case report". Medicine (Baltimore). 94 (9): e591. doi:10.1097/MD.0000000000000591. PMC 4553957. PMID 25738482.
- ↑ Druey KM, Greipp PR (2010). "Narrative review: the systemic capillary leak syndrome". Ann Intern Med. 153 (2): 90–8. doi:10.7326/0003-4819-153-2-201007200-00005. PMC 3017349. PMID 20643990.