Hyperviscosity syndrome: Difference between revisions
(Created page with "==Background== *Increased serum viscosity due to increased blood products or immunoglobulins *Causes: Waldenstrom's, IgA myeloma, polycythemia, leukemia ===Symptoms=== *heada...") |
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*Causes: Waldenstrom's, IgA myeloma, polycythemia, leukemia | *Causes: Waldenstrom's, IgA myeloma, polycythemia, leukemia | ||
==Symptoms== | |||
*headache, blurred vision, AMS, focal neuro deficits | *headache, blurred vision, AMS, focal neuro deficits | ||
*dyspnea, hypoxia, fever, fatigue | *dyspnea, hypoxia, fever, fatigue | ||
*mucosal bleeding | *mucosal bleeding | ||
==Diagnosis== | |||
*Elev. serum viscosity (>5cP) | *Elev. serum viscosity (>5cP) | ||
*Severe leukocytosis | *Severe leukocytosis | ||
*Globulin gap (Total protein - albumin) > 4 | *Globulin gap (Total protein - albumin) > 4 | ||
==Workup== | |||
*Chem, CBC | *Chem, CBC | ||
*Consider coags, UA | *Consider coags, UA | ||
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*CXR | *CXR | ||
==Treatment== | |||
*Plasmapharesis / Leukapharesis depending on cause | *Plasmapharesis / Leukapharesis depending on cause | ||
*If unavailable, phlebotomize 2-3 units, give 2-3 L IVF | *If unavailable, phlebotomize 2-3 units, give 2-3 L IVF | ||
*Supportive care | *Supportive care | ||
==Source== | |||
*Tintinalli 7th Ed. | *Tintinalli 7th Ed. | ||
*Hemingway T. Hyperviscosity Syndrome. Medscape 2015 | *Hemingway T. Hyperviscosity Syndrome. Medscape 2015 | ||
Revision as of 02:11, 4 March 2015
Background
- Increased serum viscosity due to increased blood products or immunoglobulins
- Causes: Waldenstrom's, IgA myeloma, polycythemia, leukemia
Symptoms
- headache, blurred vision, AMS, focal neuro deficits
- dyspnea, hypoxia, fever, fatigue
- mucosal bleeding
Diagnosis
- Elev. serum viscosity (>5cP)
- Severe leukocytosis
- Globulin gap (Total protein - albumin) > 4
Workup
- Chem, CBC
- Consider coags, UA
- CT brain if neuro symptoms
- CXR
Treatment
- Plasmapharesis / Leukapharesis depending on cause
- If unavailable, phlebotomize 2-3 units, give 2-3 L IVF
- Supportive care
Source
- Tintinalli 7th Ed.
- Hemingway T. Hyperviscosity Syndrome. Medscape 2015