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Systemic capillary leak syndrome resulting in compartment syndrome and the requirement for a surgical airway.
[systemic capillary leak syndrome]
We
report
on
a
case
of
systemic
capillary
leak
syndrome
associated
with
a
monoclonal
band
on
plasma
electrophoresis
.
In
our
patient
hospital
admission
was
precipitated
by
ischaemic
pain
in
the
left
lower
limb
,
associated
with
polycythaemia
,
renal
failure
and
hypovolaemic
shock
.
Fluid
resuscitation
,
venesection
and
renal
replacement
therapy
were
instituted
but
a
compartment
syndrome
developed
necessitating
surgery
.
Failure
of
tracheal
intubation
resulted
in
the
requirement
for
a
surgical
airway
.
Despite
surgical
and
resuscitative
efforts
the
outcome
was
fatal
from
hypovolaemia
and
hyperkalaemia
.
We
aim
to
highlight
the
difficulties
in
managing
this
condition
and
to
remind
healthcare
workers
to
include
it
in
the
differential
diagnoses
for
patients
presenting
with
polycythaemia
;
in
particular
polycythaemic
patients
with
a
monoclonal
band
on
plasma
electrophoresis
.