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Systemic capillary leak syndrome (SCLS) after receiving BNT162b2 mRNA COVID-19 (Pfizer-BioNTech) vaccine
  1. Masatoshi Inoue,
  2. Yu Yasue,
  3. Yoichi Kobayashi and
  4. Yutaka Sugiyama
  1. Nephrology, Tajimi Hospital, Tajimi, Japan
  1. Correspondence to Dr Masatoshi Inoue; inoue.masatoshi333{at}


Systemic capillary leak syndrome (SCLS), also known as Clarkson’s disease, is a rare disorder of unknown aetiology. Since SCLS was first described in 1960, fewer than 500 cases have been reported. SCLS is diagnosed by the classic triad of hypotension, haemoconcentration and hypoalbuminaemia resulting from fluid extravasation. Some reports show that SCLS may sometimes occur as a side effect of adenoviral vector COVID-19 vaccines, although there is only one report (two cases) of SCLS after receiving a messenger RNA vaccine. Survival rates for SCLS are very poor without treatment, so it is crucial for clinicians to recognise this disorder. A middle-aged woman who presented with generalised malaise and anasarca after receiving the BNT162b2 COVID-19 vaccine was diagnosed with SCLS. Treatment with methylprednisolone and intravenous immunoglobulin was commenced and her symptoms resolved. We expect that this case report will add to the existing literature on this rare disorder and the side effects of vaccinations.

  • immunological products and vaccines
  • renal system
  • immunology
  • adult intensive care

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  • Contributors All persons who meet the authorship criteria are listed as authors, and all authors certify that they have participated sufficiently in the work to take public responsibility for the content, including participation in the concept, design, analysis, writing or revision of the manuscript. Furthermore, each author certifies that this material or similar material has not been and will not be submitted to or published in any other publication before its appearance in BMJ Case Reports. Conception and design of study: MI, YY, YK, YS. Acquisition of data: MI. Analysis and/or interpretation of data: MI. Drafting the manuscript: MI. Revising the manuscript critically for important intellectual content: MI, YY, YK, YS. Approval of the version of the manuscript to be published: MI, YY, YK, YS.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Case reports provide a valuable learning resource for the scientific community and can indicate areas of interest for future research. They should not be used in isolation to guide treatment choices or public health policy.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.