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[Shock, hemoconcentration, and generalized edema in a 47-year-old man].
[systemic capillary leak syndrome]
We
report
the
case
of
a
47
-
year
-old
man
who
was
admitted
because
of
syncope
.
Upon
hospital
admission
,
he
rapidly
developed
circulatory
shock
with
generalized
edema
and
a
severe
hemoconcentration
with
a
hematocrit
of
70
%
.
The
condition
was
stabilized
with
infusion
of
17
l
of
cristalloid
fluids
over
a
period
of
24
h
.
After
ruling
out
possible
secondary
causes
,
the
diagnosis
of
a
systemic
capillary
leak
syndrome
--a
severe
transient
endothelial
barrier
dysfunction
of
unknown
origin--was
made
.
A
triad
of
hypotension
,
hemoconcentration
(
hematocrit
 
>
60
%
)
and
macromolecular
extravasation
is
the
typical
finding
;
furthermore
,
a
strong
association
with
monoclonal
gammopathy
of
unknown
significance
(
MGUS
)
is
described
.