Korean J Intern Med. 2007
Two Cases of Systemic Capillary Leak Syndrome that were Treated with Pentastarch
Young Seok Lee, M.D., Sun Young Kim, M.D., Chin Woo Kwon, M.D., Hae Geun Song, M.D., Young Kyung Lee, M.D., Ph.D.2 , Hyo Jung Kim, M.D., Ph.D. and Dae Young Zang, M.D., Ph.D.
Departments of Internal Medicine and Laboratory Medicine2, College of Medicine, Hallym University, Chuncheon, Korea
Systemic capillary leak syndrome (SCLS) is a condition that's caused by the shift of fluid and protein from the
intravascular space to the interstitial space as a result of repetitive episodes of capillary hyperpermeability. The
pathogenesis of SCLS is still unclear, but there's recently been a report showing this syndrome in association with
monoclonal gammopathy. This syndrome can be a fatal disease because cardiovascular collapse can occur in the
initial capillary leak phase. Although theophylline, diuretics, terbutaline, steroids, calcium antagonist, Ginkgo biloba
extracts and plasmapheresis have been suggested as medication, none of them have been proven to be effective.
Considering that this disease is self-limiting, conservative treatment in the acute phase is believed to be very important.
Because hypoalbuminemia is very a common manifestation of SCLS, Pentastarch, which has a higher molecular
weight than albumin, could be efficient to prevent cardiovascular collapse. We used 10% Pentastarch during the acute
SCLS attacks of 2 patients and the patients both showed a dramatic response. Pentastarch may be helpful to treat
SCLS in its initial capillary leak phase by the elevating blood pressure, and this might contribute to somewhat
decreasing the acute mortality of SCLS.
Keywords : Systemic capillary leak syndrome, Pentastarch, Cardiovascular collapse