A Case of IgG λ Myeloma Associated with Hyperviscosity Syndrome

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  • KATSUKI Akito
    2nd Department of Internal Medicine, Kyoto Prefectural University of Medicine
  • SHIMAZAKI Chihiro
    2nd Department of Internal Medicine, Kyoto Prefectural University of Medicine
  • OSAMURA Kichiro
    2nd Department of Internal Medicine, Kyoto Prefectural University of Medicine
  • NAKANISHI Shinobu
    2nd Department of Internal Medicine, Kyoto Prefectural University of Medicine
  • KAYAWAKE Setsuo
    2nd Department of Internal Medicine, Kyoto Prefectural University of Medicine
  • SASAKI Toru
    2nd Department of Internal Medicine, Kyoto Prefectural University of Medicine
  • MURANO Kenichi
    2nd Department of Internal Medicine, Kyoto Prefectural University of Medicine
  • NAKATA Tetsuo
    2nd Department of Internal Medicine, Kyoto Prefectural University of Medicine
  • NISHIO Akira
    2nd Department of Internal Medicine, Kyoto Prefectural University of Medicine
  • HOSODA Mitsuzo
    2nd Department of Internal Medicine, Kyoto Prefectural University of Medicine
  • HARUYAMA Harue
    2nd Department of Internal Medicine, Kyoto Prefectural University of Medicine
  • SUGISHIMAJ Kiyoaki
    2nd Department of Internal Medicine, Kyoto Prefectural University of Medicine
  • ISEMURA Takuji
    Department of Clinical Pathology, Kyoto Prefectural University of Medicine
  • IJICHI Hamao
    2nd Department of Internal Medicine, Kyoto Prefectural University of Medicine

Bibliographic Information

Other Title
  • Hyperviscosity syndromeを呈したIgG λ型myelomaの1症例
  • Hyperviscosity syndromeを呈したIgGλ型myelomaの1症例--比較的低い血清粘度における本症発症機序についての考察
  • Hyperviscosity syndrome オ テイシタ IgG ラムダガ
  • —比較的低い血清粘度における本症発症機序についての考察—
  • A Speculative Mechanism of Hyperviscosity Syndrome with Relative Low Serum Viscosity

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Description

A case of IgG λ myeloma died of acute cardiac failure due to hyperviscosity syndrome was reported.<br>Although the incidence of hyperviscosity syndrome in IgG myeloma is said to be very low (4.2%) and hyperviscosity syndrome is not associated if the relative serum viscosity is less than 5, the relative serum viscosity of the present case was rather low. In this case, plasmapheresis was very effective and possibility of amyloidosis as a cause of cardiac insufficiency was negated by ECG and UCG findings, and by histological observations of rectal mucosa. Therefore, the occurrence of hyperviscosity syndrome was suspected basing upon an idea that RBC of this patient tends to aggregate themselves to elevate whole blood viscosity, since formation of peripheral blood rouleaux was found to be so remarkable.<br>To test this possibility, viscosity of whole blood model prepared by incubating normal erythrocytes with the serum of this patient was compared with viscosities of similar models prepared by incubating normal erythrocytes of the same type with sera of various myeloma patients. As a result, it was found that the viscosity of the whole blood model of this patient is higher than the viscosities of others.<br>Hyperviscosity syndrome associated with myeloma may not be so rare because in recent years the opportunities of discovery of myeloma is increased in one hand by the advancement in immunological techniques, and the incidence of myeloma is actually increasing on the other hand, due to the expansion of aged population. It seems therefore important to measure not only serum viscosity but also whole blood viscosity whenever hyperviscosity syndrome-like symptoms are associated with advanced myeloma patients.

Journal

  • Rinsho Ketsueki

    Rinsho Ketsueki 20 (6), 658-666, 1979

    The Japanese Society of Hematology

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