A Case of Vascular Leak Syndrome During Induction Chemotherapy of Acute Lymphoblastic Leukemia (T Cell Type) .
- Author:
Kye Wool KANG
;
Hwang Min KIM
;
Won Kyu CHOI
;
Baek Keun LIM
;
Chang Hun LEE
- Publication Type:Case Report
- Keywords:
ALL;
Vascular leak syndrome
- MeSH:
Abdominal Pain;
Adolescent;
Ascites;
Blood Proteins;
Bone Marrow;
Capillaries;
Capillary Permeability;
Complement System Proteins;
Edema;
Endothelial Cells;
Endothelin-1;
Humans;
Hypoalbuminemia;
Induction Chemotherapy*;
Male;
Pleural Effusion;
Precursor Cell Lymphoblastic Leukemia-Lymphoma*;
Pulmonary Edema;
T-Lymphocytes;
Tumor Necrosis Factor-alpha;
Vincristine
- From:Journal of the Korean Pediatric Society
2001;44(9):1041-1046
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
Vascular leak syndrome(VLS) is characterized by endothelial damage, which causes extravasation of plasma proteins and fluid from capillaries into the extravascular space. It has been suggested that the increased vascular permeability is the result of an IL-2-induced suppression of endothelin-1 secretion by endothelial cells, an IL-2-induced activation of the complement cascade or TNF-alpha release from IL-2-activated T-cells. A 13-year-old male patient visited our hospital with abdominal pain. He was diagnosed with acute lymphoblastic leukemia(T cell type) by bone marrow study on his 2 nd day in hospital. On the 3 rd day of induction chemotherapy(prednisone, L-asparaginase, vincristine, intrathecal methotrexate), pulmonary edema and pleural effusion, ascites and generalized edema developed and lasted for 53 days without responding to supportive care. The laboratoy finding was that TNF-alpha was increased without evidence of infection and hypoalbuminemia was noted. It was suggested that the patient's clinical feature was induced by VLS.
