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• W2939952218 abstract "The capillary leak syndrome (CLS) is characterized by a generalized increase in vascular permeability leading to the transfer of protein-rich fluid from the intravascular to the interstitial space. 1 Siddall E. Khatri M. Radhakrishnan J. Capillary leak syndrome: etiologies, pathophysiology, and management. Kidney Int. 2017; 92: 37-46 Abstract Full Text Full Text PDF PubMed Scopus (139) Google Scholar Depletion of the intravascular volume leads to manifestations of hypovolemia, including hypotension, shock, and acute kidney injury (AKI). Expansion of the interstitial space causes pleural, pericardial, and peritoneal effusions, as well as noncardiogenic pulmonary edema, intestinal edema, and muscle edema. A variety of disorders can elicit the capillary leak syndrome, with complications of cancer chemotherapy and immunotherapy emerging as common causes. When capillary leak syndrome occurs in the context of hematologic malignancy treatment it is often referred to as cytokine release syndrome (CRS). 2 Shimabukuro-Vornhagen A. Godel P. Subklewe M. et al. Cytokine release syndrome. J Immunother Cancer. 2018; 6: 56 Crossref PubMed Scopus (781) Google Scholar The shared pathophysiology of these disorders is a surge in systemic cytokines that causes increased capillary permeability. On the cellular level, endothelial cell injury appears to be a final common pathway of cytokine-induced injury. In the idiopathic systemic capillary leak syndrome, reduced amounts of VE-cadherin at the endothelial adherens junction have been shown to cause disruption of endothelial cell architecture, which increases capillary permeability. 3 Xie Z. Ghosh C.C. Patel R. et al. Vascular endothelial hyperpermeability induces the clinical symptoms of Clarkson disease (the systemic capillary leak syndrome). Blood. 2012; 119: 4321-4332 Crossref PubMed Scopus (127) Google Scholar The role of mediators other than cytokines is unknown, and current therapies target the resulting cytokine storm. For example, anti-interleukin 6 (IL-6) antibody therapy can be used to counteract the CRS that occurs with chimeric antigen receptor T-cell (CAR T)–cell therapy. 4 Kitching A.R. Jaw J. Chimeric antigen receptor T (CAR T) cells: another cancer therapy with potential applications in kidney disease and transplantation?. Kidney Int. 2018; 94: 4-6 Abstract Full Text Full Text PDF PubMed Scopus (9) Google Scholar Despite efforts at prevention or treatment, practicing nephrologists have become increasingly familiar with CRS as a potential cause of AKI in patients undergoing treatment for malignancy." @default.
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• W2939952218 date "2019-05-01" @default.
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• W2939952218 title "Capillary leak syndrome: a cytokine and catecholamine storm?" @default.
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• W2939952218 doi "https://doi.org/10.1016/j.kint.2019.03.001" @default.
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