Ovarian hyperstemulation syndrome as a private case of iatrogenic capillary leak syndrome

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Abstract

Idiopathic capillary leak syndrome was first described in 1960 and later received its name in honor of the discoverer - Clarkson's Disease. However, in the past two decades, more cases have been reported than in the previous 35 years, most likely due to improved recognition, the widespread use of assisted reproductive technologies in the treatment of infertility and the emergence of targer therapy - monoclonal antibodies for the treatment of cancer and autoimmune diseases. Except for Clarkson's disease, capillary leak syndrome can occur in engraftment syndrome, differentiation syndrome after bone marrow transplantation, ovarian hyperstimulation syndrome, hemophagocytic lymphohistiocytosis, viral infections, mostly hemorrhagic fevers, some autoimmune diseases, administration of recombinant interleukins, cytostatics, some monoclonal antibodies including treatment with the latest anticancer drugs - immune checkpoint inhibitors, snakebite envenomation, and ricin poisoning. This syndrome is characterized by a sharp increase in vascular permeability for fluid and protein molecules that leads to the loss of fluid into the interstitium, and presents with acute onset of severe edema, often asymmetric, hypotension, polyserositis, hemoconcentration and low blood protein level. In assisted reproductive technology programs, the introduction of gonadotropins results in an increase in estradiol levels, which leads to the development of immunopathological process, accompanied by leukocyte infiltration of blood vessels and secondary hypercytokinemia. Subsequently, the secondary «wave» of cytokines and vasoactive substances secreted in response to the introduction of human chorionic gonadotropin as an ovulation trigger, leads to disruption of interendothelial contacts and the development of ovarian hyperstimulation syndrome. It is necessary to conduct a further study of the pathogenesis of capillary leak syndrome, in order to develop promising methods for the prevention and correction of ovarian hyperstimulation syndrome in assisted reproductive technology programs.

About the authors

E E Kraevaya

The Research Center for Obstetrics, Gynecology and Perinatology n.a. V.I. Kulakov

Author for correspondence.
Email: tapnatalia@yandex.ru
Moscow, Russia

Ya A Petrosyan

The Research Center for Obstetrics, Gynecology and Perinatology n.a. V.I. Kulakov

Email: tapnatalia@yandex.ru
Moscow, Russia

N I Tapil'skaya

The Research Institute of Obstetrics, Gynecology and Reproductology n.a. D.O. Ott

Email: tapnatalia@yandex.ru
Saint Petersburg, Russia

References

  1. Siddall E., Khatri M., Radhakrishnan J. Capillary leak syndrome: etiologies, pathophysiology, and ma­nagement. Kidney Int. 2017; 92 (1): 37–46. DOI: 10.1016/
  2. j.kint.2016.11.029.
  3. Druey K.M., Parikh S.M. Idiopathic systemic capillary leak syndrome (Clarkson disease). J. Allergy Clin. Immunol. 2017; 140 (3): 663–670. doi: 10.1016/j.jaci.2016.10.042.
  4. Xie Z., Ghosh C., Patel R. et al. Vascular endothelial hyperpermeability induces the clinical symptoms of Clarkson disease (the systemic capillary leak syndrome). Blood. 2012; 119 (18): 4321–4332. doi: 10.1182/blood-2011-08-375816.
  5. Yang C.-Y., Xu P., Yang Y.-J. et al. Systemic capillary leak syndrome due to systemic inflammatory response syndrome in infants: a report on 31 patients. Cent. Eur. J. Med. 2014; 9 (3): 477–480. doi: 10.2478/s11536-013-0292-0.
  6. Dejana E., Hirschi K.K., Simons M. The molecular basis of endothelial cell plasticity. Nat. Commun. 2017; 9 (8): 14361. doi: 10.1038/ncomms14361.
  7. Aroney N., Ure S., White H., Sane S. Recurrent undifferentiated shock: idiopathic systemic capillary leak syndrome. Clin. Case Rep. 2015; 3 (7): 527–530. doi: 10.1002/ccr3.280.
  8. Rahimi N. Defenders and challengers of endothelial barrier function. Front. Immunol. 2017; 8: 1847. doi: 10.3389/fimmu.2017.01847.
  9. Radeva M.Y., Waschke J. Mind the gap: mechanisms regulating the endothelial barrier. Acta. Physiol. (Oxf.). 2018; 222 (1): e12860. doi: 10.1111/apha.12860.
  10. Failla C.M., Carbo M., Morea V. Positive and negative regulation of angiogenesis by soluble vascular endothelial growth factor receptor-1. Int. J. Mol. Sci. 2018; 19 (5). pii: E1306. doi: 10.3390/ijms19051306.
  11. Heinolainen K., Karaman S., D'Amico G. et al. VEGFR3 modulates vascular permeability by controlling VEGF/VEGFR2 signaling. Circ. Res. 2017; 120 (9): 1414–1425. doi: 10.1161/CIRCRESAHA.116.310477.
  12. Leligdowicz A., Richard-Greenblatt M., Wright J. et al. Endothelial activation: the Ang/Tie axis in sepsis. Front. Immunol. 2018; 9: 838. doi: 10.3389/fimmu.2018.00838.
  13. Ghosh K., Madkaikar M., Iyer Y. et al. Syste­mic capillary leak syndrome preceding plasma cell leukaemia. Acta Haematol. 2001; 106 (3): 118–121. doi: 10.1159/000046600.
  14. Kulikov A.V., Shifman E.M., Sokologorsky S.V. et al. Ovarian hyperstimulation syndrome: emergency conditions. Clinical recommendations for intensive therapy of ovarian hyperstimulation syndrome. Status praesens. Ginekologiya, akusherstvo, besplodnyy brak. 2014; 5 (2): 103–109. (In Russ.)
  15. Feinberg E.C. Ovarian hyperstimulation: past, pre­sent, and future. Fertil. Steril. 2016; 106 (6): 1330. doi: 10.1016/j.fertnstert.2016.08.032.
  16. Griesinger G., Verweij P.J., Gates D. et al. Prediction of ovarian hyperstimulation syndrome in patients trea­ted with corifollitropin alfa or rFSH in a GnRH antagonist protocol. PLoS One. 2016; 11 (3): e0149615. doi: 10.1371/journal.pone.0149615.
  17. Miller I., Chuderland D., Grossman H. et al. The dual role of PEDF in the pathogenesis of OHSS: negating both angiogenic and inflammatory pathways. J. Clin. Endocrinol. Metab. 2016; 101 (12): 4699–4709. doi: 10.1210/jc.2016-1744.
  18. Practice Committee of the American Society for Reproductive Medicine. Prevention and treatment of mode­rate and severe ovarian hyperstimulation syndrome: a guideline. Fertil. Steril. 2016; 106 (7): 1634–1647. DOI: 10.1016/
  19. j.fertnstert.2016.08.048.
  20. Laffont S., Seillet C., Guéry J.C. Estrogen receptor-dependent regulation of dendritic cell development and function. Front. Immunol. 2017; 8: 108. doi: 10.3389/fimmu.
  21. 00108.
  22. Roved J., Westerdahl H., Hasselquist D. Sex diffe­rences in immune responses: hormonal effects, antagonistic selection, and evolutionary consequences. Horm. Behav. 2017; 88: 95–105. doi: 10.1016/j.yhbeh.2016.11.017.
  23. Bechu M.D., Rouget A., Recher C. et al. A syste­mic capillary leak syndrome (Clarkson syndrome) in a patient with chronic lymphocytic leukemia: a case report in an out-of-hospital setting. Case Rep. Emerg. Med. 2016; 2016: 5347039. doi: 10.1155/2016/5347039.
  24. Bajwa R., Starr J., Daily K. Gemcitabine-induced chronic systemic capillary leak syndrome. BMJ Case Rep. 2017; pii: bcr-2017-221068. doi: 10.1136/bcr-2017-221068.
  25. Fuentes Fernandez I., Hernandez-Clares R., Carreón Guarnizo E., Meca Lallana J.E. Capillary leak syndrome in neuromyelitis optica treated with rituximab. Mult. Scler. Relat. Disord. 2017; 16: 22–23. doi: 10.1016/j.msard.2017.06.001.
  26. Zhang F., Yang J., Li Z. Trastuzumab-induced systemic capillary leak syndrome in a breast cancer patient. Pathol. Oncol. Res. 2014; 20 (2): 435–437. doi: 10.1007/s12253-013-9713-2.
  27. Thillainathan V., Loh-Trivedi M., Rajagopal A. Pulmonary capillary leak syndrome as a result of OKT-3 therapy. Int. Anesthesiol. Clin. 2011; 49 (2): 68–70. doi: 10.1097/AIA.0b013e3181ffc029.
  28. Stebbings R., Eastwood D., Poole S., Thorpe R. After TGN1412: recent developments in cytokine release assays. J. Immunotoxicol. 2013; 10 (1): 75–82. DOI: 10.3109/
  29. X.2012.711783.
  30. Miyoshi T., Arai T., Yamashita K. et al. NB4 cells treated with all-trans retinoic acid generate toxic reactive oxygen species that cause endothelial hyperpermeability. Leuk. Res. 2010; 34 (3): 373–378. doi: 10.1016/j.leukres.
  31. 05.022.
  32. Lucchini G., Willasch A.M., Daniel J. et al. Epidemiology, risk factors, and prognosis of capillary leak syndrome in pediatric recipients of stem cell transplants: a retrospective single-center cohort study. Pediatr. Transplant. 2016; 20 (8): 1132–1136. doi: 10.1111/petr.12831.
  33. Lachmann G., Spies C., Schenk T. et al. Hemophagocytic lymphohistiocytosis: potentially underdiagnosed in intensive care units. Shock. 2018; 50 (2): 149–155. doi: 10.1097/SHK.0000000000001048.
  34. Brisse E., Wouters C.H., Andrei G., Matthys P. How viruses contribute to the pathogenesis of hemophagocytic lymphohistiocytosis. Front. Immunol. 2017; 8: 1102. doi: 10.3389/fimmu.2017.01102.
  35. Steinberg B.E., Goldenberg N.M., Lee W.L. Do viral infections mimic bacterial sepsis? The role of microvascular permeability: a review of mechanisms and methods. Antiviral Res. 2012; 93 (1): 2–15. doi: 10.1016/j.antiviral.2011.10.019.
  36. Antonen J., Leppänen I., Tenhunen J. et al. A severe case of Puumala hantavirus infection successfully treated with bradykinin receptor antagonist icatibant. Scand. J. Infect. Dis. 2013; 45 (6): 494–496. doi: 10.3109/00365548.2012.755268.
  37. Ebdrup L., Druey K., Mogensen T.H. Severe capillary leak syndrome with cardiac arrest triggered by influenza virus infection. BMJ Case Rep. 2018; pii: bcr-2018-226108. doi: 10.1136/bcr-2018-226108.
  38. Wolf T., Kann G., Becker S. et al. Severe Ebola virus disease with vascular leakage and multiorgan failure: treatment of a patient in intensive care. ­Lancet. 2015; 385 (9976): 1428–1435. doi: 10.1016/S0140-6736
  39. (14)62384-9.
  40. Kulkarni C., George T.A., Av A., Ravindran R. Acute angle closure glaucoma with capillary leak syndrome following snake bite. J. Clin. Diagn. Res. 2014; 8 (10): VC01–VC03. doi: 10.7860/JCDR/2014/10716.4924.
  41. Udayabhaskaran V., Arun Thomas E.T., Shaji B. Capillary leak syndrome following snakebite enveno­mation. Indian J. Crit. Care Med. 2017; 21 (10): 698–702. doi: 10.4103/ijccm.IJCCM_41_17.
  42. Lopez Nunez O.F., Pizon A.F., Tamama K. Ricin poisoning after oral ingestion of castor beans: a case report and review of the literature and laboratory ­testing. J. Emerg. Med. 2017; 53 (5): e67–e71. DOI: 10.1016/
  43. j.jemermed.2017.08.023.
  44. Zhang Y., Wan H., Du M. et al. Capillary leak syndrome and aseptic meningitis in a patient with Kawasaki disease: a case report. Medicine (Baltimore). 2018; 97 (23): e10716. doi: 10.1097/MD.0000000000010716.
  45. Prete M., Urso L., Fatone M.C. et al. Antiphospholipids syndrome complicated by a systemic capillary leak-like syndrome treated with steroids and intravenous immunoglobulins: a case report. Medicine (Baltimore). 2016; 95 (5): e2648. doi: 10.1097/MD.0000000000002648.
  46. Guffroy A., Dervieux B., Gravier S. et al. Systemic capillary leak syndrome and autoimmune diseases: a case series. Semin. Arthritis Rheum. 2017; 46 (4): 509–512. doi: 10.1016/j.semarthrit.2016.08.001.

© 2019 Kraevaya E.E., Petrosyan Y.A., Tapil'skaya N.I.

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