hyperviscosity

Wikipedia preview

出典(authority):フリー百科事典『ウィキペディア（Wikipedia）』「2016/07/09 18:44:39」(JST)

wiki en

[Wiki en表示]

Hyperviscosity syndrome is a group of symptoms triggered by increase in the viscosity of the blood. Symptoms of high blood viscosity include spontaneous bleeding from mucous membranes, visual disturbances due to retinopathy, and neurologic symptoms ranging from headache and vertigo to seizures and coma.

Hyperviscosity occurs from pathologic changes of either cellular or protein fractions of the blood such as is found in polycythemias, multiple myeloma (particularly IgA and IgG3), leukemia, monoclonal gammopathies such as Waldenström macroglobulinemia, sickle cell anemia, and sepsis.

Types of hyperviscosity syndromes vary by pathology; including serum hyperviscosity, which may cause neurologic or ocular disorders; polycythemic hyperviscosity, which results in reduced blood flow or capillary perfusion and increased organ congestion; and syndromes of hyperviscosity, caused by reduced deformability of red blood cells, often evident in sickle cell anemia.

Cause

High cell counts are seen in conditions such as polycythemia (raised red blood cells) or leukemia (more white blood cells, especially in acute leukemic blast crises).

May occur with a white blood cell count greater than 100,000.

Diagnosis

Although elevated whole blood viscosity is a better measure of hyperviscosity and more common and clinically important, serum viscosity and plasma viscosity are more frequently measured. Normal plasma viscosity is between 1.4 and 1.8 centipoise while symptoms from hyperviscosity typically occur greater than 4 centipoise (about 4 times more viscous than water) and require emergency treatment.

Patients will also have evidence of their underlying disorder. Those with myeloma will typically display a rouleaux formation on a peripheral smear and a large globulin gap, indicative of a significant paraprotein load. While viscosity can be directly measured, results can take a few days to return and thus a high index of suspicion is required to make the diagnosis in a timely manner. If hyperviscosity is suspected, treatment may need to be started prior to obtaining the official viscosity level.

Treatment

Plasmapheresis may be used to decrease viscosity in the case of myeloma, whereas leukapheresis or phlebotomy may be employed in a leukemic or polycythemic crisis, respectively. Blood transfusions should be used with caution as they can increase serum viscosity. Hydration is a temporizing measure to employ while preparing pheresis. Even after treatment, the condition will recur unless the underlying disorder is treated.

See also

• Bing-Neel syndrome
• Waldenström macroglobulinemia

References

External links

• MedlinePlus Encyclopedia 000536 - "Hyperviscosity - newborn"
• 1134166044 at GPnotebook

UpToDate Contents

全文を閲覧するには購読必要です。 To read the full text you will need to subscribe.

• 1. 免疫グロブリンによる過粘稠度症候群における血漿交換 plasma exchange in the hyperviscosity syndrome due to immunoglobulins
• 2. ワルデンシュトレーム型マクログロブリン血症の疫学、病因、臨床症状、および診断 epidemiology pathogenesis clinical manifestations and diagnosis of waldenstrom macroglobulinemia
• 3. 多発性骨髄腫の合併症の治療 treatment of the complications of multiple myeloma
• 4. 新生児多血症 neonatal polycythemia
• 5. クリオグロブリンおよびクリオグロブリン血症の概要 overview of cryoglobulins and cryoglobulinemia

English Journal

• The role of cystatin C as a biomarker for prognosis in pulmonary arterial hypertension due to congenital heart disease.

• Blok IM1, van Riel AC1, Schuuring MJ2, de Bruin-Bon RH2, van Dijk AP3, Hoendermis ES4, Zwinderman AH2, Mulder BJ1, Bouma BJ5.
• International journal of cardiology.Int J Cardiol.2016 Apr 15;209:242-7. doi: 10.1016/j.ijcard.2016.02.003. Epub 2016 Feb 6.
• BACKGROUND: Adults with pulmonary arterial hypertension due to congenital heart disease (PAH-CHD) have a poor prognosis. Identifying patients with a high risk for clinical events and death is important because their prognosis can be improved by intensifying their treatment. Cystatin C, a novel cardi
• PMID 26897077

• [Changes in the prognosis and treatment of Waldenström macroglobulinemia. Literature overview and own experience].

• Adam Z, Pour L, Krejčí M, Ševčíková S, Pourová E, Ševčíková E, Král Z, Mayer J.
• Vnitr̆ní lékar̆ství.Vnitr Lek.2016 Spring;62(1):25-39.
• Waldenström macroglobulinemia is defined by the presence of monoclonal immunoglobulin IgM type (M-IgM) and evidence of lymphoplasmacytic bone marrow infiltration. The disease has an indolent course, the treatment is only initiated when the disease has begun to damage its carrier. The following symp
• PMID 26967234

• Prevalence of thrombophilic disorders in takotsubo patients: the (ThROmbophylia in TAkotsubo cardiomyopathy) TROTA study.

• Cecchi E1, Parodi G2, Fatucchi S2, Angelotti P2, Giglioli C2, Gori AM3,4, Bandinelli B3, Bellandi B2, Sticchi E3, Romagnuolo I3, Mannini L2, Antoniucci D2, Abbate R3.
• Clinical research in cardiology : official journal of the German Cardiac Society.Clin Res Cardiol.2016 Mar 22. [Epub ahead of print]
• Takotsubo cardiomyopathy (TTC) pathophysiology is still unclear. A transient intracoronary thrombosis dissolved at the time of angiography has been hypothesized. We aimed to evaluate the prevalence of thrombophilic disorders in TTC patients. In 75 TTC women, 75 age- and sex-matched acute coronary sy
• PMID 27003690

Japanese Journal

• 症例 腫瘤性および間質性肺病変を呈し,高Ca血症を伴った原発性マクログロブリン血症の1例

• 山根 宏美,柏原 光介,田中 秀幸
• 日本呼吸器学会誌 = Annals of the Japanese Respiratory Society 3(1), 111-115, 2014-01-10
• NAID 40019962384

• Antivasospastic Effects of Hydroxyfasudil, a Rho-Kinase Inhibitor, After Subarachnoid Hemorrhage

• Satoh Shin-ichi,Takayasu Masakazu,Kawasaki Koh [他],IKEGAKI Ichiro,HITOMI Asako,YANO Kazuo,SHIBUYA Masato,ASANO Toshio
• Journal of pharmacological sciences 118(1), 92-98, 2012-01-20
• … The results also suggest that hydroxyfasudil contributes to the potency of fasudil to prevent cerebral vasospasm and hyperviscosity and suggest the potential utility of hydroxyfasudil as a therapeutic agent for patients with SAH. …
• NAID 10030454320

• ネフローゼ症候群における血栓合併症

• 井庭 慶典,杉本 圭相,柳田 英彦,岡田 満,竹村 司
• Nihon Shoni Jinzobyo Gakkai Zasshi 24(1), 54-59, 2011
• 　血栓発症の背景にはさまざまな基礎疾患が存在し，さらに動脈血栓と静脈血栓ではその基礎疾患や発症病態も異なる。臨床的には単一因子ではなく，多くのリスク因子が混在し血栓が発症すると考えられる。ネフローゼ症候群は血栓形成の基礎疾患として重要であり，合併症として静脈血栓症はよく知られており，その発症には血液粘稠度の亢進に加え，凝固阻止因子の低下が発症の原因と考えられている。今回，ネフローゼ症候群の再発時に …
• NAID 130001353977

Related Links

• Hyperviscosity Syndrome - Diseases & Conditions ...

Hyperviscosity syndrome (HVS) refers to the clinical sequelae of increased blood viscosity. Increased serum viscosity usually results from increased circulating serum immunoglobulins and can be seen in such diseases ...

• Polycythemia - newborn: MedlinePlus Medical Encyclopedia

The outlook is good for infants with mild hyperviscosity. Good results are also possible in infants who receive treatment for severe hyperviscosity. The outlook will depend largely on the reason for the condition. Some children may have ...

Related Pictures