Jin Yee Ho

A previously healthy 51-year-old man presented complaining of leg swelling for 2 months. Physical examination revealed lymphadenopathies in both inguinal areas. Computed tomography (CT) showed enlarged LNs throughout the body above and below the diaphragm. The serum lactate dehydrogenase (LDH) level was mildly elevated at 241 (normal, 100–225) IU/L.

We reviewed the medical records of 321 consecutive drug-naïve patients with PD who had visited the outpatient clinic for movement disorders at the Severance Hospital between April 2009 and September 2015. PD was diagnosed according to the clinical diagnostic criteria of the United Kingdom PD Society Brain Bank.

ISCLS is a very rare disorder characterized by recurrent episodes of shock, hypoalbuminemia, and hemoconcentration. It is caused by a dysfunction of the vascular endothelium that leads to shift of fluid and proteins from the intravascular space to the interstitial space [1,2,3, 8]. The patient in the present case experienced two similar fatal attacks of hypovolemic shock, AKI, hypoalbuminemia, and hemoconcentration within a short duration of 4 months.