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Systemic capillary leak syndrome secondary to decompression sickness
  1. Akshay Mathavan1,
  2. Akash Mathavan1,
  3. Kirk Jones1 and
  4. Ali Ataya2
  1. 1Internal Medicine, University of Florida, Gainesville, Florida, USA
  2. 2Division of Pulmonary, Critical Care and Sleep Medicine, University of Florida, Gainesville, Florida, USA
  1. Correspondence to Akshay Mathavan; amathavan1996{at}


Systemic capillary leak syndrome is a rare derangement of endothelial function characterised by extravasation of plasma and proteins into the interstitial space. Primary capillary leak syndrome is a rare, episodic medical illness of unknown molecular pathology while secondary capillary leak syndrome may be precipitated by any number of inflammatory and infectious syndromes. Decompression sickness, a disorder of depressurisation, has been identified as a very rare trigger. We present a structured case report of systemic capillary leak syndrome secondary to decompression sickness following deep diving, informing physicians of this potential complication. No pharmacological therapy has substantial evidence in the treatment of acute systemic capillary leak syndrome. By review of current recommendations for acute management, we also emphasise an observed positive response to judicious fluid resuscitation and an oral cyclic AMP-elevating agent (ie, terbutaline).

  • Adult intensive care
  • Cardiovascular system

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  • Contributors Akshay M conceived of the idea for the case report and was primarily responsible for writing the manuscript. Akash M helped with background research and assisted with writing the manuscript. KJ contributed to background research and manuscript drafting. AA assisted with writing the manuscript, provided subject matter expertise and is responsible for its final content.

  • 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.