Hyperviscosity alters blood flow dynamics. A marked elevation in viscosity is associated with thrombosis.
Patient selection: hyperviscosity
Causes of hyperviscosity may include:
(1) myeloma and macroglobulinemia
(2) hypergammaglobulinemia from other cause (vaccination, infection, other)
(3) severe hyperglycemia
(4) iatrogenic
A patient with hyperviscosity often has multiple risk factors for thrombosis.
A patient with a past history of thromboemboli may be at increased risk.
The risk associated with hyperviscosity can be addressed by:
(1) using plasmapheresis to reduce blood viscosity
(2) treating the source (for example, chemotherapy for myeloma)
(3) avoiding iatrogenic causes of a transient increase in viscosity
(4) provide anticoagulation prophylaxis during periods of high risk
