Granulocyte colony-stimulating factor-induced capillary leak syndrome confirmed by extravascular lung water measurements
Granulocyte colony-stimulating factor-induced capillary leak syndrome confirmed by extravascular lung water measurements
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DOI：
10.1007/s00277-004-0946-8
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发表时间：
2005-02-01
影响因子：
3.5
通讯作者：
Malbrain, MLNG
中科院分区：
文献类型：
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作者：
Deeren, DH;Zachee, P;Malbrain, MLNG
研究目的是报告第一例粒细胞集落刺激因子（G-CSF）诱导的毛细血管渗漏综合征（CLS），其中进行了系列血管外肺水（EVLW）测量，并将该病例与既往报告的病例进行比较。为了识别之前报告的病例，我们使用PubMed进行了文献检索，检索词如下：CLS、EVLW、G-CSF、粒细胞-巨噬细胞集落刺激因子（GM-CSF）和干细胞移植以及文献目录中的参考文献检索到的论文。为了获得关于这些案件的更多信息，我们通过电子邮件与作者联系。我们描述的情况下，一个68岁的妇女谁开发严重的CLS在G-CSF治疗自体造血干细胞移植后。CLS是由内皮细胞损伤引起的，导致血浆蛋白和液体从毛细血管外渗到血管外空间。EVLW和肺血管通透性的高值说明了这一点，需要机械通气。我们在文献中发现了另外五个病例报告。CLS发作时的白色血细胞计数从极低（0）到极高（90，500/穆尔）不等。症状开始于G-CSF治疗的第5 - 9天。所有患者均有发热。3例患者接受机械通气，4例接受肾脏替代治疗。两名患者死亡。用G-CSF治疗可诱发致命性CLS。监测严重CLS患者的EVLW可能有助于指导液体治疗和改善氧合。
The study purpose was to report the first case of granulocyte colony-stimulating factor (G-CSF)-induced capillary leak syndrome (CLS) in which serial extravascular lung water (EVLW) measurements were performed and to compare this case with previously reported cases. To identify previously reported cases, we performed a literature search, using PubMed with the following search terms: CLS, EVLW, G-CSF, granulocyte-macrophage colony-stimulating factor (GM-CSF) and stem cell transplantation and the references in the bibliographies of the papers retrieved. To obtain additional information about these cases, we contacted the authors by e-mail. We describe the case of a 68-year-old woman who developed severe CLS during G-CSF treatment after autologous haematological stem cell transplantation. CLS is caused by damage to the endothelial cells, resulting in extravasation of plasma proteins and fluid from the capillaries into the extravascular space. This is illustrated by high values of EVLW and pulmonary vascular permeability, necessitating mechanical ventilation. We found five other case reports in the literature. The white blood cell count at the onset of the CLS varied from very low (zero) to very high (90,500/mul). The symptoms began on day 5 - 9 of the G-CSF treatment. All patients had fever. Three patients were mechanically ventilated and four received renal replacement therapy. Two patients died. Treatment with G-CSF can induce fatal CLS. Monitoring of EVLW in patients with severe CLS may be useful to guide fluid therapy and improve oxygenation.