Monday, 18 October 2010

MRCP revision battle 33.2: Hyperviscosity syndrome

Hyperviscosity syndrome is a condition in which the viscosity (='stickiness') of the blood has increased to a degree which prevents easy flow through the microcirculation.

This causes symptoms such as:
  • lethargy
  • confusion
  • headache
  • visual disturbances
  • spontaneous bleeding

The visual disturbance is described as 'looking through a watery car windscreen'
The optic disc may occur blurred.

Normal plasma viscosity is 1.4-1.8.  Hyperviscosity syndrome develops above around 4.

Causes of hyperviscosity syndrome include:
  • myeloma
  • Waldenstroms macroglobulinaemia
  • leukaemias
  • polycythaemia

Treatment depends on the cause; in myeloma/waldenstroms the patient needs plasmaphersis whereas in polycythaemia the treatment is venesection.

So now seems a good time to battle Waldenstrom's macroglobulinaemia...