Systemic capillary leak syndrome in childhood

With the decrease of mortality rates and establishment of new therapeutic r egimes in intensive care medicine and oncology during the last decade,we se e an increase of patients developing a systemic capillary leak syndrome. Th e described symptoms represent consequences of the loss of capillary fluids to third space by increased permeability. The patients present with genera lized edema, pleural or pericardial effusion, ascites, weight gain, tachyca rdia, hypotension, and prerenal failure. Whereas the idiopathic episodic fo rm (Clarkson disease) is rare in children, the symptomatic forms triggered by systemic inflammatory response is seen more frequently in children than in adults. Therapy: Treatment of systemic capillary leak syndrome is empiri c and supportive. The main specific therapeutic goat is to stop the cause o f inflammation,whenever possible. Additional treatment are catecholamines a nd volume replacement for stabilization of blood pressure, mechanical venti lation and dialysis. Specific therapeutic regimes have not yet been investi gated in controlled studies.