Disease relevance of Capillary Leak Syndrome

• Peripheral eosinophilia is almost invariably observed during the course of interleukin-2 (IL-2) therapy and is frequently accompanied by the development of a capillary leak syndrome characterized by edema, weight gain, and oliguria [1].
• Major toxic side effects including fever, hepatic dysfunction, and weight gain associated with the capillary leak syndrome were associated with exogenous IL-2 administration [2].
• These results suggest that although circulating IL-2-inducible cytokines such as TNF and IFN-gamma may activate EC in vivo and contribute to lymphocyte margination and lymphopenia, they may not be directly responsible for the IL-2-induced capillary leak syndrome and may actually protect EC from LAK cell-mediated injury [3].
• CONCLUSION: The regimen of terbutaline and aminophylline effectively prevents the attacks of hypotension and hemoconcentration that occur in systemic capillary leak syndrome [4].
• One patient died from a 'capillary leak' syndrome that may have been attributable to Ara-C toxicity [5].

High impact information on Capillary Leak Syndrome

• C1-inhibitor concentrate for sepsis-related capillary leak syndrome [6].
• Epoprostenol in systemic capillary leak syndrome [7].
• Treatment of the systemic capillary leak syndrome with terbutaline and theophylline. A case series [8].
• The major adverse event ascribed to rhu GM-CSF was a capillary leak syndrome in three patients graded as severe in two patients, moderate in one, and reversible in all three patients [9].
• The release of toxic eosinophil products at extravascular sites and in the circulation may contribute to the pathogenesis of the capillary leak syndrome complicating IL-2 therapy [1].

Chemical compound and disease context of Capillary Leak Syndrome

• The purpose of this study was to determine the effectiveness of aminophylline and terbutaline in the treatment of systemic capillary leak syndrome [4].
• Thalidomide for systemic capillary leak syndrome [10].
• The capillary leak syndrome with decreased GFR and renal water and sodium retention after recombinant interleukin-2 (IL-2) administration may arise from endothelial activation via an increase in prostaglandin synthesis [11].
• Disappearance of pulmonary capillary leak syndrome when intravenous cyclosporine is replaced by oral cyclosporine [12].
• Gemcitabine-induced systemic capillary leak syndrome [13].

Biological context of Capillary Leak Syndrome

• CONCLUSION: Activated human PMNs are directly angiogenic by releasing VEGF, and this has important implications for inflammation, capillary leak syndrome, wound healing, and tumor growth [14].
• As leukotrienes, derived from arachidonic acid via the 5-lipoxygenase pathway, enhance capillary permeability, we studied arachidonate metabolism in leucocytes of a patient with capillary leak syndrome [15].

Anatomical context of Capillary Leak Syndrome

• Life-threatening capillary leak syndrome after G-CSF mobilization and collection of peripheral blood progenitor cells for allogeneic transplantation [16].
• We tested the hypothesis that 'capillary leak syndrome' following systemic interleukin-2 (IL-2) therapy resulted from a cascade of events leading to the induction of NO which, directly or indirectly, injured capillaries and caused fluid leakage [17].
• Dysactivation of the immune system during an acute insult, with the subsequent release of humoral mediators from activated immune cells, leads to tissue injury and may be involved in the pathogenesis of ARDS, DIC, capillary leak syndrome, and to the development of multiple organ system failure [18].

Gene context of Capillary Leak Syndrome

• Severe capillary leak syndrome has been reported only with IL-4 [19].
• On the basis of previous results, we undertook a randomised controlled study to investigate the priming with plasma rich in the C4A isotype of complement component 4 on the incidence of capillary leak syndrome in children with C4A deficiency [20].
• INTERPRETATION: In paediatric patients with C4A deficiency, C4A-rich plasma priming reduces the incidence of CPB-related capillary leak syndrome by blocking the activated C4 increase and attenuating the systemic inflammatory response after CPB [20].
• These results demonstrate that during treatment with IL-2 and IFN-alpha-2a there are both fluid retention and augmented filtration of fluid from the vascular to the interstitial compartment, but no indication for a capillary leak syndrome [21].
• The severe side effects usually associated with classical lymphokine-activated killer therapy in association with high doses of interleukin 2, such as "capillary leak syndrome," were absent in this study [22].

Analytical, diagnostic and therapeutic context of Capillary Leak Syndrome

• During cardiopulmonary bypass, patients with capillary leak syndrome also had lower concentrations of complement proteins C3 and C4 but not C1 inhibitor [23].
• We report a case of capillary leak syndrome in a 37-year-old female PBPC donor who received G-CSF 900 microg/day for 4 days and underwent leukapheresis [16].
• Activation of the complement system during immunotherapy of cancer with interleukin-2: a possible explanation of the capillary leak syndrome [24].
• Noncardiogenic pulmonary edema (capillary leak syndrome) developed in a 61-year-old woman after methylmethacrylate was inserted for total hip replacement [25].

References