ALB and viral hemorrhagic fever: Except sepsis, other diseases can also result in CLS, such as engraftment syndrome, viral hemorrhagic fevers, and snakebite envenomation.[2] CLS caused by various diseases shares the same underlying pathophysiologic abnormality, damage of capillary endothelial cells and increase in capillary permeability to albumin.[2,10] In a study of CLS, Atkinson et al estimated that the capillaries are unable to retain macro-molecules smaller than 200 kDa (the molecular weight of albumin is 66.5 kDa).