Annals of internal medicine · 1999
Treatment of the systemic capillary leak syndrome with terbutaline and theophylline. A case series.
Клинический случайСтатьяПоддержка службы здравоохранения СШАНазвание и аннотация: Перевод в очереди
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Tahirkheli N K, Greipp P R
Аннотация
BACKGROUND: The systemic capillary leak syndrome is a rare idiopathic disorder characterized by recurrent episodes of hypotension and hemoconcentration due to sudden transient extravasation of 10% to 70% of plasma. Mortality rates 5 years after diagnosis have been reported to be 76%.
OBJECTIVE: To assess the efficacy of a prophylactic regimen for the systemic capillary leak syndrome.
DESIGN: Case series.
SETTING: Tertiary referral center.
PATIENTS: Eight patients followed over the past 18 years.
INTERVENTION: Oral terbutaline plus aminophylline or theophylline.
MEASUREMENTS: Long-term clinical follow-up.
RESULTS: During a median follow-up of 9 years (range, 2 to 18 years), two patients (25%) died: one during an acute episode and one of complications related to long-term corticosteroid therapy. The other six patients are alive and healthy. The frequency and severity of the episodes decreased by a median of 30-fold. Recurrences were associated with decreased serum theophylline levels, possibly caused by enzyme induction or autoinduction. The extended-release form of medication was more successful. Sympathomimetic side effects were significant.
CONCLUSIONS: A regimen of terbutaline and theophylline seems to be effective prophylaxis against the systemic capillary leak syndrome. Maintenance of therapeutic drug levels was associated with favorable results.
OBJECTIVE: To assess the efficacy of a prophylactic regimen for the systemic capillary leak syndrome.
DESIGN: Case series.
SETTING: Tertiary referral center.
PATIENTS: Eight patients followed over the past 18 years.
INTERVENTION: Oral terbutaline plus aminophylline or theophylline.
MEASUREMENTS: Long-term clinical follow-up.
RESULTS: During a median follow-up of 9 years (range, 2 to 18 years), two patients (25%) died: one during an acute episode and one of complications related to long-term corticosteroid therapy. The other six patients are alive and healthy. The frequency and severity of the episodes decreased by a median of 30-fold. Recurrences were associated with decreased serum theophylline levels, possibly caused by enzyme induction or autoinduction. The extended-release form of medication was more successful. Sympathomimetic side effects were significant.
CONCLUSIONS: A regimen of terbutaline and theophylline seems to be effective prophylaxis against the systemic capillary leak syndrome. Maintenance of therapeutic drug levels was associated with favorable results.