Coupled Plasma Filtration Adsorption for Treatment of Capillary Leak Syndrome Superimposed to Acute Generalized Exanthematous Pustolosis: A Case Report
| Autor: | Giorgio Berlot, Giuliano Boscutti, Francesco Bianco, Ugo Gerini, Martina Cozzi, Vittorio Di Maso, Elisa Bedina, Diego Signoretto, Elisa Olivo |
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| Přispěvatelé: | Di Maso, Vittorio, Cozzi, Martina, Gerini, Ugo, Bedina, Elisa, Olivo, Elisa, Bianco, Francesco, Signoretto, Diego, Berlot, Giorgio, Boscutti, Giuliano |
| Jazyk: | angličtina |
| Rok vydání: | 2020 |
| Předmět: |
Adult
medicine.medical_specialty medicine.medical_treatment 030232 urology & nephrology Generalized edema Acute generalized exanthematous pustulosis 030204 cardiovascular system & hematology Gastroenterology Sepsis Capillary leak syndrome Coupled plasma filtration adsorption Cytokines Hydroxychloroquine 03 medical and health sciences 0302 clinical medicine Internal medicine medicine Humans Renal replacement therapy Cytokine Acute generalized exanthematous pustulosi Septic shock business.industry Hematology General Medicine medicine.disease Nephrology Shock (circulatory) Female Adsorption Hemofiltration medicine.symptom business medicine.drug Capillary Leak Syndrome |
| Popis: | Coupled plasma filtration adsorption (CPFA) is an extracorporeal supportive therapy based on nonspecific adsorption of pro- and anti-inflammatory mediators combined with continuous renal replacement therapy. The main field of CPFA application is septic shock, and there are limited data about its efficacy in the treatment of other acute conditions characterized by a dysregulation in immune homeostasis. Capillary leak syndrome (CLS) defines a life-threatening condition sustained by hypercytokinemia and characterized by abrupt onset of increased capillary permeability leading to severe generalized edema and hypovolemic shock refractory to fluid administration. Therapy for CLS is not specific and, at present time, it consists in the use of steroids or intravenous immunoglobulins. We present the case of a 34-year-old woman who developed CLS superimposed to acute generalized exanthematous pustulosis after initiating therapy with hydroxychloroquine for undifferentiated connective tissue disease. CLS did not respond to steroids and intravenous immunoglobulins, while it was successfully treated with CPFA. This observation supports the possible role of CPFA in restoring a proper immunologic homeostasis not only in sepsis but also in other devastating conditions sustained by hypercytokinemia. |
| Databáze: | OpenAIRE |
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