Hyperviscosity syndrome

Reference work entry
DOI: https://doi.org/10.1007/3-540-29662-X_1304


Often found in paraproteinemias most common Waldenström's macroglobulinemia, polycythemia, leukocytosis; symptoms include visual changes, headache, vertigo, nystagmus, dizziness, sudden deafness, diplopia, ataxia, confusion, dementia, stroke or coma. A classic triad includes visual changes, bleeding and neurological complaints. Most symptoms of hyperviscosity syndrome occur with levels >4 centipoises (normal </=1.8). Most patients are symptomatic with a CP >6. These findings are due to decreased microcirculation perfusion and stasis due to sludging of the circulating serum. Most urgent care is needed when CNS, ophthalmic, or cardiopulmonary system involvement is suspected.



Treatment is dependent upon cause but usually comprises of either leukapheresis/plasmapharesis and/or phlebotomy followed by chemotherapy against the offending pathology.


  1. Marx J, et al (2002) Rosen's Emergency Medicine: Concepts and Clinical Practice, 5th ed, Mosby, Philadelphia, p 1706Google Scholar

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