Symptoms Associated with Plasma Hyperviscosity

Description

An increase in plasma proteins due to myeloma or Waldenstrom's macroglobulinemia may result in an increase in the plasma viscosity. This increase may be associated with the onset of signs and symptoms affecting multiple organ systems. Reduction in plasma viscosity may reverse some symptoms if performed prior to end organ damage.

Viscosity is discussed in Chapter 3 (Hematology).

(1) The normal relative viscosity is 1.4 to 1.8.

(2) The symptoms of hyperviscosity may begin when the relative viscosity is >= 4.

(3) Viscosity > 6 is usually accompanied by symptoms.

(4) Most symptoms will reverse with reduction in viscosity unless end-organ damage has occurred.

Signs and Symptoms Associated with Hyperviscosity

Weakness and/or fatigue

Anorexia

Weight loss

Coagulopathy (oozing of blood from mucous membranes, nose bleeds, GI bleeding, hematuria, oozing from surgical sites)

Anemia

Visual disturbances (diplopia, partial or complete loss of vision, distended retinal vessels, retinal hemorrhages, papillodema, retinal vein thrombosis)

Distended conjunctival vessels with hemorrhage

Headache

Dizziness and/or vertigo

Nausea

Nystagmus

Ataxia

Decreased mental status (somnolence, stupor, coma)

Psychiatric changes (psychosis, etc.)

Generalized seizures

Hemiparesis

Hearing loss

Postural hypotension

Congestive heart failure

Angina pectoris

Hypotension

Peripheral hypoperfusion, peripheral vascular disease

Hypervolemia (expanded plasma volume)

Impaired renal function (microinfarcts, glomerular deposits, glomerular-tubular dysfunction)

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Symptoms Associated with Plasma Hyperviscosity

Description

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