Hyperviscosity syndrome

Guillaume Dumas (1, 2) , Paul Gabarre (1) , Naike Bige (1) , Eric Maury (3, 1)

1 CHU Saint-Antoine [AP-HP]
2 UPMC - Université Pierre et Marie Curie - Paris 6
3 iPLESP - Institut Pierre Louis d'Epidémiologie et de Santé Publique

A 47-year-old man was admitted to the intensive care unit for stupor and dyspnea. He reported a 3-day history of blurry vision and nosebleeds. Laboratory tests revealed hyperproteinemia at 161 g/L (reference range 60–80 g/L). Funduscopic examination revealed bilateral retinal hemorrhages with venous dilation and tortuosity (Fig. 1) confirming the diagnosis of hyperviscosity syndrome. Serum protein immunofixation assay identified an IgG kappa monoclonal immunoglobulin and bone marrow aspiration revealed infiltration by dystrophic plasma cells, consistent with multiple myeloma. All the patient’s complaints disappeared after two rounds of plasmapheresis.

Domaines: Hématologie; Cancer

Guillaume Dumas, Paul Gabarre, Naike Bige, Eric Maury. Hyperviscosity syndrome. Intensive Care Medicine, In press, ⟨10.1007/s00134-018-5087-y⟩. ⟨hal-01787150⟩