see also:

• a rare episodic disorder characterised but increased permeability of capillary walls and loss of plasma protein into the tissues which may be life threatening
• no clear definite hereditary pattern
• mainly affects healthy middle aged people
• aka Clarkson syndrome
• rarely may be precipitated by Astra-Zeneca Covid-19 vaccine (less than 1 in 10 million doses)

• lasts 1-3 days during which up to 70% of plasma may leak into the tissues

• reabsorption of the initially extravasated fluid and albumin from the tissues, and it usually lasts 1 to 2 days
• this may cause intravascular fluid overload leading to polyuria and can cause flash pulmonary edema and cardiac arrest

• may initially have URTI or gastro-like symptoms or limb aches before developing thirst, light-headedness as a result of reduced blood volume and hypotension (systolic BP < 90mmHg)
• systemic or peripheral oedema usually is present often with cold peripheries
• acute kidney injury (AKI) / acute renal failure (ARF) may occur
• rhabdomyolysis may occur from oedema causing compartment syndromes
• lab features:
  • raised haematocrit due to plasma loss
  • hypoalbuminaemia
  • a paraprotein in the blood (an monoclonal gammopathy of uncertain significance (MGUS) in approximately 80% of cases)

• generally require close monitoring in ICU watching for compartment syndrome and APO which will require usual Mx
• support BP with albumin but this generally is transient effect and creates more oedema
• corticosteroids

• IVIG seems to provide the best long term outcomes