[Idiopathic systemic capillary leak syndrome - a rare but serious differential diagnosis in the hypovolemic patient].

Idiopathic systemic capillary leak syndrome (SCLS) is a rare, life-threatening cause of hypovolemic shock characterized by hemoconcentration, hypoalbuminemia, and acute hypovolemia due to plasma extravasation. It should be suspected in patients presenting with unexplained hypotension and markedly elevated hemoglobin levels, often following nonspecific prodromal symptoms such as malaise. Management is supportive and includes aggressive crystalloid resuscitation, vasopressor therapy, corticosteroids, and intravenous immunoglobulins. Owing to the risk of rapid hemodynamic deterioration and multi--organ failure, intensive care monitoring is essential. We report a previously healthy middle-aged man with recent upper respiratory tract infection and syncope who developed fulminant SCLS with refractory shock and died despite intensive care treatment.