Hyperviscosity syndrome - a case report

Abstract

Hyperviscosity syndrome (HVS) refers to an increase in serum viscosity secondary to circulating proteins. It can be a result of an hyperproliferation of blood components such as seen en polycythemia and acute leukemias or a consequence of an increase in immunoglobulins.1,2 HVS is most common in patients with Waldenström’s macroglobulinemia (WM), followed by multiple myeloma and leukemia.2,3 The clinical manifestations of HVS include a variety of symptoms like visual symptoms, altered mental status, stroke or congestive heart failure. The diagnosis of HVS should be suspected if it is presented the triad of mucosal or skin bleeding, visual abnormalities and neurologic deficits.3,4 Prompt treatment is needed to avoid progression to multisystem organ failure. The diagnosis is made by clinical and laboratory findings, like increased serum protein levels and increased serum viscosity. Management comprises supportive treatment and plasmapheresis.2,4 We report a case of a patient with HVS as a presentation of WM.