Therapeutic plasma exchange for hyperviscosity syndrome in IgA multiple myeloma.

Nalan Yurtsever, Thomas C Binns, Jeanne E Hendrickson, Christopher A Tormey, Edward S Lee
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Abstract

Hyperviscosity syndrome (HVS) is defined as the symptomatic presentation of increased blood thickness due to various clinical conditions such as hypergammaglobulinemia. HVS secondary to immunoglobulin (Ig)A multiple myeloma has been infrequently reported. Although the efficiency of IgM or IgG removal by therapeutic plasma exchange (TPE) is well described, the efficiency of IgA removal by TPE is not as well known. Here, we describe a case of HVS due to IgA myeloma in a patient who received 2 TPE treatments, with subsequent symptomatic improvement as well as decrease in IgA and viscosity levels.

治疗性血浆置换用于治疗 IgA 多发性骨髓瘤的高粘滞性综合征。
血液粘稠度增高综合征(HVS)是指由于高丙种球蛋白血症等各种临床疾病引起的血液粘稠度增高的症状表现。继发于免疫球蛋白(Ig)A 多发性骨髓瘤的 HVS 鲜有报道。虽然治疗性血浆置换术(TPE)清除 IgM 或 IgG 的效率已得到很好的描述,但 TPE 清除 IgA 的效率却鲜为人知。在此,我们描述了一例因 IgA 骨髓瘤导致的 HVS 患者,该患者接受了两次 TPE 治疗,随后症状改善,IgA 和粘度水平下降。
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