Arteritis associated with hyperviscosity-like syndrome in rheumatoid arthritis, treated by intermittent plasma-exchange for 2.5 years.

A case is reported of a hyperviscosity-like syndrome in a 53-year-old male suffering from rheumatoid arthritis. The clinical presentation was an acute abdomen, peripheral neuritis, otovestibular areflexy, and central retinal vein thrombosis (papilloedema and retinopathy with venous engorgement, haemorrhages and exudates). Plasma viscosity was normal and whole blood viscosity, measured with an Oswald viscometer, was slightly elevated. The patient had markedly elevated rheumatoid factor tire and fibrinogen level. Histologically, there were no signs of arteritis in the mesentery. Intermittent plasma-exchange resulted in general improvement and no new vascular accidents after 2.5 years.