Introduction: Systemic capillary leak syndrome (SCLS) is an increasingly recognized rare syndrome. Its diagnosis is suggested by the occurrence of edema with arterial hypotension, hemoconcentration, and paradoxical hy...Introduction: Systemic capillary leak syndrome (SCLS) is an increasingly recognized rare syndrome. Its diagnosis is suggested by the occurrence of edema with arterial hypotension, hemoconcentration, and paradoxical hypoalbuminemia. SCLS can be idiopathic (Clarkson syndrome) or secondary. Secondary SCLS (SSCLS) is mainly triggered by infections (especially viruses), drugs (antitumor therapy), malignancies, and inflammatory diseases. We report a case of systemic capillary leak syndrome secondary to the COVID-19 infection. Observation: A 74-year-old chronic smoker with no particular history was initially admitted to the intensive care unit (ICU) with a picture of respiratory distress secondary to a COVID-19 infection with favorable evolution, hence his transfer to the emergency services. On Day 8 of hospitalization, following the installation of arterial hypotension, not responding to filling, associated with hypoalbuminemia, and generalized edematous syndrome, and in the absence of any other explanation for this clinical picture, a SCLS secondary to COVID-19 infection was suggested. On the balance sheet, after the discovery of acute renal failure, serum creatinine went from 7.9 mg/l to 16.6 mg/l with microalbuminuria at 420 mg/24h and leukocyturia at 20 elements/mm<sup>3</sup> without germ-evoked tubulointerstitial nephritis (TIN) secondary to a viral infection with COVID-19. The evolution was marked by the spontaneous regression of the edema and the normalization of the blood pressure figures. Discussion: The classic triad combining hypotension, hemoconcentration, and hypoalbuminemia suggests the diagnosis of SCLS once all other causes of shock have been ruled out. Hemoconcentration is less constant in SSCLS than in ISCLS. This is the case with our patient. The exact pathophysiological process of SCLS is largely unknown. Viral infections are the most common infectious cause of SCLS. The kidneys are the second-most common organs affected by the SARS-Cov-2 coronavirus infection. The presence of nephritis can be used展开更多
目的:探讨益气升陷活血方及其拆方对心梗后心衰低血压大鼠心肌Ⅰ、Ⅲ型胶原的影响。方法:采用大鼠心脏左冠状动脉结扎术,建立心衰模型,将LVEF值≤50%、尾动脉收缩压≤90 mm Hg的大鼠随机分为4组,即心衰低血压组、益气升陷活血方组、益...目的:探讨益气升陷活血方及其拆方对心梗后心衰低血压大鼠心肌Ⅰ、Ⅲ型胶原的影响。方法:采用大鼠心脏左冠状动脉结扎术,建立心衰模型,将LVEF值≤50%、尾动脉收缩压≤90 mm Hg的大鼠随机分为4组,即心衰低血压组、益气升陷活血方组、益气升陷组、活血化瘀组,灌胃干预8周。用免疫组化及RT-PCR检测心肌Ⅰ、Ⅲ型胶原,并实时定量PCR检测心肌Ⅰ、Ⅲ型胶原m RNA的含量。结果:与心衰低血压组比较,所有治疗组心肌Ⅰ、Ⅲ型胶原含量及m RNA的含量均降低(P<0.05);与活血化瘀治疗组比较,益气升陷组、全方治疗组,心肌Ⅰ、Ⅲ型胶原m RNA的含量均降低,全方治疗组更显著(P<0.05)。结论:全方治疗组、益气升陷组、活血化瘀组能减轻心梗后心衰大鼠心肌纤维化的程度,减少心肌Ⅰ、Ⅲ型胶原的含量,其中全方治疗组较益气升陷治疗组、活血化瘀治疗组的改善作用明显,益气升陷组次之。展开更多
文摘Introduction: Systemic capillary leak syndrome (SCLS) is an increasingly recognized rare syndrome. Its diagnosis is suggested by the occurrence of edema with arterial hypotension, hemoconcentration, and paradoxical hypoalbuminemia. SCLS can be idiopathic (Clarkson syndrome) or secondary. Secondary SCLS (SSCLS) is mainly triggered by infections (especially viruses), drugs (antitumor therapy), malignancies, and inflammatory diseases. We report a case of systemic capillary leak syndrome secondary to the COVID-19 infection. Observation: A 74-year-old chronic smoker with no particular history was initially admitted to the intensive care unit (ICU) with a picture of respiratory distress secondary to a COVID-19 infection with favorable evolution, hence his transfer to the emergency services. On Day 8 of hospitalization, following the installation of arterial hypotension, not responding to filling, associated with hypoalbuminemia, and generalized edematous syndrome, and in the absence of any other explanation for this clinical picture, a SCLS secondary to COVID-19 infection was suggested. On the balance sheet, after the discovery of acute renal failure, serum creatinine went from 7.9 mg/l to 16.6 mg/l with microalbuminuria at 420 mg/24h and leukocyturia at 20 elements/mm<sup>3</sup> without germ-evoked tubulointerstitial nephritis (TIN) secondary to a viral infection with COVID-19. The evolution was marked by the spontaneous regression of the edema and the normalization of the blood pressure figures. Discussion: The classic triad combining hypotension, hemoconcentration, and hypoalbuminemia suggests the diagnosis of SCLS once all other causes of shock have been ruled out. Hemoconcentration is less constant in SSCLS than in ISCLS. This is the case with our patient. The exact pathophysiological process of SCLS is largely unknown. Viral infections are the most common infectious cause of SCLS. The kidneys are the second-most common organs affected by the SARS-Cov-2 coronavirus infection. The presence of nephritis can be used
