capillary leak syndromeの併発を疑った膿疱性乾癬

・感染症を契機に膿疱性乾癬が悪化した症例で，その治療中に，尿量減少，クレアチニンの上昇，浮腫や体重増加を認め，capillary leak syndrome（CLS）の併発を疑った．

・循環動態をモニタリングしながら，アルブミン製剤や利尿薬を投与したところ症状は改善した．

・CLSはまれな病態ではあるが，致死的な経過をたどることがあるため，早期診断と早期治療介入が重要である．

（「症例のポイント」より）

　

A case of generalized pustular psoriasis complicated with indefinite capillary leak syndrome

　

Jimura, Nozomi1）Higashi, Yuko1）Kanekura, Takuro1） 1）Department of Dermatology, Kagoshima University Hospital

　

A 58-year-old woman had generalized pustular psoriasis (GPP) and received etretinate. GPP flared up subsequent to a common cold. Erythema and pustules relapsed on her trunk and extremities. Concurrently, high fever and leg edema appeared, laboratory examination returned decreased serum albumin and elevated creatinine, and her urine volume decreased. Based on these findings, capillary leak syndrome was suspected. We carefully managed her with albumin preparation and diuretics monitoring her hemodynamics.