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Research Letter
January 26, 2009

A Novel Therapy for Lymphedema

Arch Intern Med. 2009;169(2):201-202. doi:10.1001/archinternmed.2008.580

There is a broad differential to consider when evaluating a patient with angioedema, which can include capillary leak syndrome and lymphedema. Systemic capillary leak syndrome typically presents with hypotension, hemoconcentration, hypoalbuminemia, monoclonal gammopathy, and marked plasma leakage resulting in diffuse edema.1 Prophylactic treatment with terbutaline sulfate and theophylline has been found to be effective for the prevention of systemic capillary leak syndrome exacerbations.2

The other unusual consideration is lymphedema, which is notoriously resistant to therapy, and only supportive measures are available (physical therapy, external compression, and surgery). We describe herein a patient with lymphedema who benefited from treatment with theophylline and terbutaline.