Serum Hyperviscosity Syndrome

The hyperviscosity syndrome commonly includes mucous membrane bleeding, retinopathy and loss of vision, and neurological disorders associated with elevated serum viscosity. These changes can be lethal. Hyperviscosity, however, can be relieved by adequate plasmapheresis, and recognition of the hyperviscosity syndrome is important for the institution of the proper therapy. The association of elevated serum viscosity with marked hypergammaglobulinemia has been recognized for more than 30 years. Between 1932 and 1937 Reismann,1Magnus-Levy,2and Albers3reported increased serum viscosity in several patients with multiple myeloma. In 1944 Waldenstrom described an elevated serum viscosity in patients with macroglobulinemia.4These findings have been extended in recent years by the delineation of a group of clinical symptoms attributable to increased viscosity of the blood.5-10 The hyperviscosity syndrome is frequently seen in patients with macroglobulinemia, with or without demonstrable lymphoma, but only rarely with multiple myeloma. Manifestations of the hyperviscosity