Idiopathic systemic capillary leak syndrome (SCLS) is a rare, life-threatening cause of hypovolemic shock that should be suspected in patients with unexplained hypotension and markedly elevated hemoglobin; in the reported case, a previously healthy middle-aged man developed fulminant SCLS with refractory shock and died despite intensive care treatment.
SCLS is a rare, life-threatening cause of hypovolemic shock defined by hemoconcentration, hypoalbuminemia, and acute hypovolemia due to plasma extravasation.
SCLS should be suspected in patients with unexplained hypotension and markedly elevated hemoglobin, often after nonspecific prodromal symptoms.
Management of SCLS is supportive and includes aggressive crystalloid resuscitation, vasopressor therapy, corticosteroids, and intravenous immunoglobulins.
A previously healthy middle-aged man with a recent upper respiratory tract infection and syncope developed fulminant SCLS with refractory shock and died despite intensive care treatment.
This case report describes a rare and dangerous condition called idiopathic systemic capillary leak syndrome. In it, fluid leaks out of the blood vessels into surrounding tissues. Blood pressure then falls sharply, and the blood becomes concentrated, with high hemoglobin and low albumin levels. The authors describe a previously healthy middle-aged man who had a recent upper respiratory tract infection and fainted. He developed a severe form of the syndrome with shock that did not respond to treatment, and he died despite intensive care. The report emphasizes that the condition can worsen very quickly and lead to failure of multiple organs. This research suggests that doctors should consider this syndrome when a patient has unexplained low blood pressure together with a markedly elevated hemoglobin level, especially after vague early symptoms such as malaise. Treatment is supportive and involves large amounts of intravenous fluid, medicines to support blood pressure, corticosteroids, and intravenous immunoglobulins, with close intensive care monitoring. As a single case report, it illustrates the condition rather than measuring how often it occurs or how well treatments work.
Hylander J, Andersson H, von Seth M. (2026). [Idiopathic systemic capillary leak syndrome - a rare but serious differential diagnosis in the hypovolemic patient].. Lakartidningen. https://doi.org/10.65868/URRP6393