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Hyperviscosity syndrome

Parvez M Lokhandwala, Maryam Shabihkhani, Paul M Ness, Evan M Bloch
Hyperviscosity syndrome (HVS) is most commonly associated with Waldenstrom's macroglobulinemia, where it may be life-threatening. HVS may also occur in autoimmune diseases; data pertaining to efficacy of therapeutic plasma exchange (TPE) in HVS arising in non-malignant gammopathy are limited. We report a case of 71-year-old female with erosive rheumatoid arthritis with profoundly elevated rheumatoid factor (57,400 IU/ml; normal <35) who presented with findings consistent with HVS: profound weakness, headache, epistaxis and plasma viscosity (8...
February 15, 2018: Transfusion and Apheresis Science
Sevgi Kalayoglu-Besisik
Hyperviscosity syndrome (HVS) develops most commonly in Waldenström's macroglobulinemia (WM) and multiple myeloma (MM). Plasmapheresis is the immediate therapy and very effective at relieving symptoms by removing paraprotein. The most commonly used replacement fluid is 4%-5% human albumin in physiologic saline. FFP may be used in patients with coagulation abnormalities. Plasmapheresis should be continued until acute symptoms abate. Hyperviscosity impairs the circulation in the retina and causes hemorrhages around the small retinal vessels...
February 20, 2018: Transfusion and Apheresis Science
Guillaume Dumas, Paul Gabarre, Naike Bigé, Eric Maury
No abstract text is available yet for this article.
February 23, 2018: Intensive Care Medicine
Wenlong Wang, Xiaohui Huang, Yiyong Sun, Jinying Zhang
This study investigated the changes in the blood rheology of patients with angina pectoris and ischemia reperfusion injury and their effect on thromboxane B2 (TXB2) levels to examine their relationship. Forty patients with unstable angina pectoris who underwent elective percutaneous coronary intervention (PCI) were selected for the unstable angina group (UA group) and forty patients deemed free of coronary heart disease by coronary angiography were selected for the control group. Venous blood samples were drawn from all participants; patients in the UA group had blood drawn 1 day before and 1 day after the PCI procedure...
January 2018: Experimental and Therapeutic Medicine
Solam Lee, Noo Ri Lee, Sung Jay Choe, Beom Jun Kim, Minseob Eom, Eung Ho Choi
Waldenstrom's macroglobulinemia (WM) is lymphoplasmacytoid malignancy that affects B lymphocytes. Cutaneous involvement of WM is rare, but various cutaneous manifestations have been reported. These findings are due to various pathological processes including direct invasion of tumor cells into the skin, deposition of paraproteins, hyperviscosity syndrome, and cryoglobulinemia. A 64-year-old man presented with a 10-day history of pruritic erythematous papules and plaques on his trunk and elbows. The clinical features were suspicious for eczematous dermatitis...
February 2018: Annals of Dermatology
Badia Belarj, Amine El Alaoui, Souhail Dahraoui, Jean Uwingabiye, Emmanuel Millbank Owusu, Anas Rochdi, Asmaa Biaz, Abdellah Dami, Sanae Bouhsain, Zohra Ouzzif, Nawfel Doghmi, Samira El Machtani Idrissi
We are highlighting on the particularity of a clinical picture of pulmonary embolism revealing light-chain myeloma in a 56-year-old male patient. Myeloma remains a rare affection. Even though its revelation through pulmonary embolism remains rare, it can be explained by hyperviscosity syndrome accompanying it.
December 2017: Clinical Case Reports
Leanne Grech, Adrian Mifsud, Maryanne Caruana, Francis Carbonaro
Eisenmenger syndrome refers to reversal of shunt and central cyanosis due to pulmonary hypertension induced by congenital heart disease with a large systemic-to-pulmonary shunt. We report a case of a 17-year-old man with Eisenmenger syndrome who presented with gradual deterioration in visual acuity and was diagnosed with advanced secondary open angle glaucoma. There have been reports of patients suffering from thrombosis due to hyperviscosity associated with this syndrome; however, to our knowledge, the association of secondary open angle glaucoma with Eisenmenger syndrome has not yet been documented...
2017: Case Reports in Ophthalmological Medicine
Zachary N Gastelum, Diana M Biggs, Aaron Scott
This case report describes a 54-year-old, asymptomatic man who presented with hyperkalemia on routine lab testing who was later found to have acute renal failure, unresponsive to fluid resuscitation, with minimal improvement after hemodialysis. After a comprehensive evaluation ruled out common causes of acute renal failure, the patient underwent testing with a bone survey, urine protein electrophoresis (UPEP), serum protein electrophoresis (SPEP), and immunoelectrophoresis for suspected plasma cell dyscrasia and received plasmapheresis for hyperviscosity syndrome and nephrotoxicity, which resulted in improved renal function...
September 20, 2017: Curēus
(no author information available yet)
Renal impairment (RI) is a common complication of multiple myeloma (MM), which is presented as chronic kidney disease (CKD) or acute kidney injury (AKI). The typical pathological feature is cast nephropathy. Presently international system staging (ISS) is used in evaluating MM. Although the classic Durie-Salmon staging system could be still used in clinical practice, it may miss out some patients with renal impairment. For evaluations of RI in MM patients with CKD, it's recommended to assess the estimated glomerular filtration rate (eGFR) by creatinine based formula CKD-epidemiology collaboration (EPI) or modification of diet in renal disease(MDRD) and to stage the renal injuries according to 2013 Kidney Disease Improving Global Outcomes (KDIGO) CKD guidelines...
November 1, 2017: Zhonghua Nei Ke za Zhi [Chinese Journal of Internal Medicine]
Umar A Khan, Carl B Shanholtz, Michael T McCurdy
Prevalence of cancer and its various related complications continues to rise. Increasingly these life-threatening complications are initially managed in the emergency department, making a prompt and accurate diagnosis crucial to effectively institute the proper treatment and establish goals of care. The following oncologic emergencies are reviewed in this article: pericardial tamponade, superior vena cava syndrome, brain metastasis, malignant spinal cord compression, and hyperviscosity syndrome.
December 2017: Hematology/oncology Clinics of North America
Neil B Newman, Vidya Puthenpura, Stephanie Mischell, Gabriela Ferreira
Multiple myeloma (MM) rarely presents with a primary neurological dysfunction, and if it does it is usually due to a plasmacytoma. This is the first case to discuss hypoglossal nerve dysfunction as the first sign of MM progression secondary to severe pathophysiologic bone lysis. A PubMed-based literature search was completed on April 17, 2016 for the terms "multiple myeloma" and "hypoglossal nerve neuropathy". A 73-year-old woman with known MM who received little treatment for several years, presented secondary to dysarthria and at first was thought to have hyperviscosity syndrome...
February 2017: World Journal of Oncology
Yu-Yen Chen, Shwu-Jiuan Sheu, Hsiao-Yun Hu, Dachen Chu, Pesus Chou
OBJECTIVE: To investigate a possible association between retinal vein occlusion (RVO) and an increased risk of developing acute myocardial infarction (AMI). DESIGN: A population-based retrospective cohort study using the entire population of the Taiwan National Health Insurance Research Database (NHIRD) from 1st January, 2001 to 31st December, 2013. METHODS: A total of 37921 subjects with RVO were enrolled in the RVO group, and 113763 subjects without RVO were enrolled in the comparison group...
2017: PloS One
Sundeep Shenoy, Safal Shetty, Shilpa Lankala, Faiz Anwer, Andrew Yeager, Sasikanth Adigopula
Oncologic emergencies can present either as a progression of a known cancer or as the initial presentation of a previously undiagnosed cancer. In most of these situations, a very high degree of suspicion is required to allow prompt assessment, diagnosis, and treatment. In this article, we review the presentation and management of cardiovascular oncologic emergencies from primary and metastatic tumors of the heart and complications such as pericardial tamponade, superior vena cava syndrome, and hyperviscosity syndrome...
2017: Cardiology
Shiho Satomi, Asuka Kasai, Eisuke Hamaguchi, Yasuo M Tsutsumi, Katsuya Tanaka
Waldenström's macroglobulinemia (WM) manifests as hyperviscosity syndrome. Cryoglobulinemia, which may increase blood viscosity or induce thrombosis in association with decreased body temperature, can occur in combination with WM. We describe the management of an 82-year-old woman with WM, hyperviscosity syndrome, and cryoglobulinemia who required open aortic valve replacement. Decreased body temperature in this patient was prevented during cardiopulmonary bypass by using a forced air warming system and normothermic cardioplegia with continuous warm blood cardioplegia perfusion...
September 15, 2017: A & A Case Reports
U Kassner, M Dippel, E Steinhagen-Thiessen
Severe hypertriglyceridemia is defined at a plasma triglyceride (TG) concentration of >885 mg/dl and may result - in particular when clinical symptoms appear before the age of 40 - from "large variant" mutations in genes which influence the function of the lipoprotein lipase (LPL). For diagnosis, secondary factors have to be excluded and treated before further genetic tests are considered. Typical symptoms in almost all patients are recurrent, sometimes severe abdominal pain attacks, which can result in acute pancreatitis, the most important, sometimes life-threatening complication...
August 2017: Der Internist
V C Müller, N Mihailovic, C R Clemens, F Alten, N Eter
We present a case of a 57-year-old woman who reported bilateral visual impairment since 2 weeks. She had a medical history of congenital, cyanotic heart failure. Funduscopic examination revealed serous retinal detachment on the left side, central subneurosensory detachment on the right side, retinal vessel tortuosity and multiple retinal haemorrhages in the periphery. As blood analysis showed a distinct increase in haemoglobin and haematocrit, hyperviscosity syndrome was suspected to have caused bilateral serous retinal detachment...
May 15, 2017: Der Ophthalmologe: Zeitschrift der Deutschen Ophthalmologischen Gesellschaft
Thilo Gambichler, Stefanie Strutzmann, Andrea Tannapfel, Laura Susok
BACKGROUND: Paraneoplastic acral vascular syndrome (PAVS) is a rare phenomenon which is observed in patients with adenocarcinomas and other malignancies. Various potential pathogenic mechanisms such as tumour invasion of sympathetic nerves, hyperviscosity, hypercoagulability, vasoactive tumour-secreted substances, and immunological mechanisms have been suggested. CASE PRESENTATION: We report a 60-year-old Caucasian male attended our hospital with a bulky lymph node mass in the right axilla...
May 12, 2017: BMC Cancer
Rene Y Choi, Rachel Jacoby, Akbar Shakoor
PURPOSE: To report the clinical course of a patient with ocular manifestations of hyperviscosity syndrome associated with Waldenström macroglobulinemia, and for the first time, video imaging of mobile emboli in the conjunctival and retinal vasculature. METHODS AND PATIENT: A 60-year-old woman with newly diagnosed Waldenström macroglobulinemia, with no visual complaints was evaluated by the Ophthalmology service for a baseline ocular examination. RESULTS: At presentation, ocular examination revealed a visual acuity of 20/25 in each eye...
March 22, 2017: Retinal Cases & Brief Reports
J T Jo, D Schiff
Patients with brain tumors and systemic malignancies are subject to diverse neurologic complications that require urgent evaluation and treatment. These neurologic conditions are commonly due to the tumor's direct effects on the nervous system, such as cerebral edema, increased intracranial pressure, seizures, spinal cord compression, and leptomeningeal metastases. In addition, neurologic complications can develop as a result of thrombocytopenia, coagulopathy, hyperviscosity syndromes, infection, immune-related disorders, and adverse effects of treatment...
2017: Handbook of Clinical Neurology
Aurélie Lemaire, Nathalie Parquet, Lionel Galicier, David Boutboul, Rémi Bertinchamp, Marion Malphettes, Guillaume Dumas, Eric Mariotte, Marie-Noëlle Peraldi, Virginie Souppart, Benoit Schlemmer, Elie Azoulay, Emmanuel Canet
BACKGROUND: Data on plasma exchange therapy in the intensive care unit (ICU) setting are scarce. We aimed to describe the technical aspects and the adverse events associated with the procedure in critically ill patients. METHODS: All adult patients treated by plasma exchange in the medical ICU of the Saint-Louis university hospital between January 1, 2013 and March 31, 2015 were prospectively included. RESULTS: We report on 260 plasma exchange procedures performed in 50 patients...
December 2017: Journal of Clinical Apheresis
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