Hyperviscosity Syndrome
Basics
Description
Description
- Hyperviscosity syndrome (HVS) is the clinical consequence of increased blood viscosity
- The classic clinical symptoms are the triad of mucosal bleeding, visual disturbances, and neurologic signs
- Viscosity is the resistance a material has to change in form
- The higher the blood viscosity, the more the internal resistance to blood flows
- Increased cardiac output is required to provide adequate perfusion of hyperviscous blood
- Oxygen delivery is impaired as transit through the microcirculatory system slows. This impaired microcirculatory oxygenation gives rise to the clinical symptoms of this syndrome
Etiology
Etiology
- Hyperviscosity occurs when there is elevation of either the cellular or acellular components of circulating blood
- Acellular (protein) hyperviscosity:
- The most common cause (85–90%) of hyperviscosity is increased concentration of γ globulins:
- Monoclonal gammopathies: From malignant diseases like Waldenstrom macroglobulinemia and multiple myeloma
- Polyclonal gammopathies: Usually rheumatic diseases (very rare)
- The most common cause (85–90%) of hyperviscosity is increased concentration of γ globulins:
- Cellular (blood cell) hyperviscosity:
- Much less common (10–15%)
- Increased numbers of RBC, as in polycythemia vera
- Increased concentration (>100,000) of WBC, as in acute and chronic leukemia
- Thrombocytosis
There's more to see -- the rest of this topic is available only to subscribers.
Citation
Schaider, Jeffrey J., et al., editors. "Hyperviscosity Syndrome." 5-Minute Emergency Consult, 6th ed., Lippincott Williams & Wilkins, 2020. Emergency Central, emergency.unboundmedicine.com/emergency/view/5-Minute_Emergency_Consult/307255/all/Hyperviscosity_Syndrome.
Hyperviscosity Syndrome. In: Schaider JJJ, Barkin RMR, Hayden SRS, et al, eds. 5-Minute Emergency Consult. Lippincott Williams & Wilkins; 2020. https://emergency.unboundmedicine.com/emergency/view/5-Minute_Emergency_Consult/307255/all/Hyperviscosity_Syndrome. Accessed December 11, 2024.
Hyperviscosity Syndrome. (2020). In Schaider, J. J., Barkin, R. M., Hayden, S. R., Wolfe, R. E., Barkin, A. Z., Shayne, P., & Rosen, P. (Eds.), 5-Minute Emergency Consult (6th ed.). Lippincott Williams & Wilkins. https://emergency.unboundmedicine.com/emergency/view/5-Minute_Emergency_Consult/307255/all/Hyperviscosity_Syndrome
Hyperviscosity Syndrome [Internet]. In: Schaider JJJ, Barkin RMR, Hayden SRS, Wolfe RER, Barkin AZA, Shayne PP, Rosen PP, editors. 5-Minute Emergency Consult. Lippincott Williams & Wilkins; 2020. [cited 2024 December 11]. Available from: https://emergency.unboundmedicine.com/emergency/view/5-Minute_Emergency_Consult/307255/all/Hyperviscosity_Syndrome.
* Article titles in AMA citation format should be in sentence-case
TY - ELEC
T1 - Hyperviscosity Syndrome
ID - 307255
ED - Barkin,Adam Z,
ED - Shayne,Philip,
ED - Rosen,Peter,
ED - Schaider,Jeffrey J,
ED - Barkin,Roger M,
ED - Hayden,Stephen R,
ED - Wolfe,Richard E,
BT - 5-Minute Emergency Consult
UR - https://emergency.unboundmedicine.com/emergency/view/5-Minute_Emergency_Consult/307255/all/Hyperviscosity_Syndrome
PB - Lippincott Williams & Wilkins
ET - 6
DB - Emergency Central
DP - Unbound Medicine
ER -