Trombosis de la vena central de la retina (TVCR) bilateral asociada a síndrome de hiperviscosidad en una Macroglobulinemia de Waldenström (MW) - a propósito de un caso / Bilateral central retinal vein thrombosis (TVCR) associated with hyperviscosity syndrome in a Waldenström Macroglobulinemia (MW) - a case report

Introducción: la Macroglobulinemia de Waldenström (MW) es un tipo raro de linfoma de células B caracterizado por la proliferación de células linfoplasmocíticas que secretan altas cantidades de inmunoglobulinas M (IgM) monoclonales. Puede presentarse con una amplia gama de síntomas, entre ellos los derivados del aumento de la viscosidad plasmática. Métodos: reportamos un caso de MW que presentó una trombosis de la vena central de la retina (TVCR) bilateral en el contexto de un síndrome de hiperviscosidad (SHV). El objetivo de este trabajo fue revisar algunos aspectos clínicos de la MW, con especial énfasis en el SHV y la TVCR. Resultados: las manifestaciones clínicas y de laboratorio de la MW son inespecíficas y comunes a otras neoplasias hematológicas. El SHV se produce cuando los niveles de IgM sobrepasan los 3 mg/dL, situación que ocurre en un 15-30 por ciento de los pacientes. La TVCR es una complicación grave y rara asociada al SHV, presentándose típicamente como una pérdida de agudeza visual indolora. El fondo de ojo exhibe signos característicos, como tortuosidad venosa y hemorragias retinales hasta la periferia, y la angiografía con fluorosceína y la OCT pueden orientar al diagnóstico y guiar el manejo. El tratamiento incluye la plasmaféresis y tratamientos oftalmológicos basados en agentes antioangiogénicos. Conclusión: la MW es una enfermedad incurable. Sin embargo, es importante sospechar una TVCR en pacientes que debutan con una pérdida de agudeza visual, ya que existen tratamientos efectivos en el manejo de esta complicación. (AU)

Introduction: Waldenstrom's Macroglobulinemia (WM) is a rare type of B-cell lymphoma characterized by proliferation of lymphoplasmocitarian cells that secrete high amounts of monoclonal immunoglobulin M (IgM). It may present with a wide range of symptoms, including the ones that derivatives of the increase in plasma viscosity. Methods: we report a case of WM that presented a bilateral central retinal vein occlusion (CRVO) in the context of a hyperviscosity syndrome (HVS). The objective of this study was to review clinical aspects of the WM, with special emphasis on the HVS and the CRVO. Results: the WM laboratory and clinical manifestations are common to other hematological malignancies. The HVS occurs when levels of IgM exceed 3 mg/dL, situation that occurs in 15-30 percent of patients. The CRVO is a serious and rare complication associated with the HVS, typically presented as a painless visual acuity loss. The fundoscopic examination exhibits characteristic signs, such as venous tortuousity and retinal hemorrhages in all four quadrants and most numerous in the periphery; angiography with fluoroscein and the OCT can orientate the diagnosis and guide the management. The treatment includes plasmapheresis and other ophthlamological treatments based on antiangiogenic agents. Conclusion: the WM is an incurable disease. However, it is important to suspect a CRVO in patients who made their debut with a loss of visual acuity, since there are effective treatments in the management of this complication.(AU)

Síndrome de hiperviscosidad como presentación de la macroglobulinemia de waldenström: Reporte de caso / Waldenström's macroglobulinemia presenting as hyperviscosity syndrome. Case report

La Macroglobulinemia de Waldenström (MW) es una neoplasia hematológica infrecuente, caracterizada por presentar gammapatía monoclonal de IgM e infiltración linfoplasmocítica en la médula ósea. Representa cerca del 1-2% de las neoplasias malignas hematológicas y es importante diferenciarla de otros procesos linfoproliferativos como la gammapatía monoclonal de significado incierto (MGUS) y de otros trastornos asociados a IgM.Suele debutar con síntomas inespecíficos, o ser un hallazgo de laboratorio, pudiendo presentar malestar general, astenia, baja de peso, o bien un cuadro poco frecuente producido por el aumento de la concentración de IgM sérica, denominado síndrome de hiperviscosidad. Éste corresponde a una urgencia hematológica que debe ser tratada precozmente ya que conlleva consecuencias graves para el paciente. Reportamos el caso de una mujer de 64 años con antecedente de MGUS IgM que progresa a Macroglobulinemia de Waldenström con síndrome de hiperviscosidad, presentado manifestaciones clínicas inespecíficas que al inicio minimiza, pero que conlleva a lesiones retinianas extensas. Dado la gravedad del cuadro, requiere manejo con plasmaféresis en unidad de paciente crítico.

Waldenström's macroglobulinemia is an infrequent hematological neoplasm characterized by Ig M monoclonal gammopathy and lymphoplasmacytic infiltration of the bone marrow. It accounts for 1-2% of malignant hematological neoplasms and it is important to distinguish it from other lymphoproliferative disorders such as monoclonal gammopathy of undetermined significance and other disorders involving IgM. It usually presents with non-specific symptoms, or is a laboratory finding, and may present as general malaise, weakness, weight loss or, rarely, hyperviscosity syndrome caused by a rise in the levels of circulating IgM. This is a hematological emergency which must be treated at once as it can have serious consequences for the patient. We report a case of a 64 year old woman with previously diagnosed monoclonal gammopathy of undetermined significance who progressed to Waldenström´s macroglobulinemia with hyperviscosity syndrome and minimal non-specific clinical signs which led to extensive retinal lesions. Given the seriousness of her condition she was treated with plasmapheresis in Intensive Care.

Efecto de la hiperviscosidad seminal sobre la integridad acrosómica y la movilidad espermática antes y después de la criopreservación. / Effect of seminal hyperviscosity on acrosomal integrity and sperm motility before and after cryopreservation

La criopreservación del semen es una herramienta útil en la reproducción asistida, la cual puede tener impacto en las características espermáticas durante el congela miento y el descongelamiento. El objetivo de este estudio fue valorar la integridad del acroso ma y la movilidad de los espermatozoides criopreservados y descongelados provenientes de muestras hiperviscosas y no viscosas. Se realizó el espermograma, la integridad del acrosoma, el espermocultivo y los niveles de los marcadores de glándulas accesorias en 60 muestras de semen. Cada alícuota de semen fue inmersa en un crioprotector comercial para congelar a -196°C. Transcurridos 30 días, éstas fueron descongeladas y en el sedimento celular espermá ticesuspendido se evaluó la movilidad y la integridad acrosómica, disminuyendo significa tivamente la movilidad progresiva (p<0,05), la vitalidad espermática (p<0,005) y la integridad acrosómica (p<0,05); dicho descenso fue más evidente en las muestras hiperviscosas. La viscosidad del semen fresco se relacionó inversamente con la movilidad y la integridad del acrosoma antes y después del congelamiento (p<0,05). En veinte muestras de semen se iden tificó la presencia de microorganismos y de anticuerpos IgA anti C. trachomatis , de las cuales quince muestras en la reproducción hiperviscosas. El aumento de la viscosidad seminal y los niveles de ácido cítrico están asociados con disfunción prostática, baja movilidad espermática y reacción prematura del acrosoma, lo que puede reducir la capacidad fecundante de un esper matozoide. La etiología de la hiperviscosidad sigue siendo compleja; sin embargo, para pre servar la movilidad y la integridad del acrosoma, previamente deben investigarse sus causas en las muestras seminales que van a ser sometidas a la criopreservación.

Semen cryopreservation is a useful tool in assisted reproduction, which may have impact on sperm characteristics during freezing and thawing. The aim of this study was to assess the integrity of the acrosome and motility of cryopreserved and thawed spermatozoos in hyperviscous and no viscous samples. In semen samples spermiogram, glandular markers, acrosome integrity, culture and the levels markers accessory glands were measured. Each ali quot of semen was immersed in cryoprotectant and maintained in a commercial freezer at -196 ° C. After 30 days, these were thawed and in the cell pellet resuspended, spermatic motility and acrosomal integrity were evaluated. In thawed samples, there were significant decreases in progressive motility (p <0.05), vitality (p <0.005) and acrosome integrity (p <0.05) with respect to fresh sperm, this decline was most evident in hyperviscous samples. The viscosity of fresh semen was inversely related to motility and acrosome integrity before and after freezing (p <0.05). Twenty semen samples showed the presence of microorganisms and C. trachomatis IgA antibodies, of which fifteen showed hyperviscosity. Biochemical analysis demonstrated that semen samples with low levels of citric acid had less acrosomal integrity both before and after freezing (p <0.05). The viscoelasticity and citric acid levels are associated with prostate dys function, low sperm motility and premature acrosome reaction, which can reduce the fertilizing capacity of sperm. The etiology of hyperviscosity remains complex; however, to preserve mo tility and acrosome integrity, its causes must be investigated previously in the seminal samples to be subjected to cryopreservation.

Factores bioquímicos y nutricionales asociados a la viscosidad sanguínea en adultos de la sierra urbana (Imbabura), Ecuador / Biochemical and nutritional factors associated with blood viscosity in adults living in a mountain chain, (Imbabura), Ecuador

La asociación de la viscosidad sanguínea (VS) con la hipertensión y la diabetes mellitus 2, indica que debe ser considerada sobre todo en poblaciones que viven en la sierra donde el hematocrito y la hemoglobina son más elevados. Se evaluó la asociación de la VS con factores de riesgo cardiovascular y de síndrome metabólico (SM) en una población de 237 adultos (20-60 años) de la sierra urbana ecuatoriana. Se calculó el índice de masa corporal (IMC), porcentaje de grasa y agua corporal, se midieron la circunferencia de la cintura (CC) y la presión arterial. Se realizaron determinaciones de parámetros bioquímicos, hematológicos y de VS (mediante fórmula validada). El 14,76% de la población presentó hiperviscosidad (HV). El 42,8% de las personas con HV presentó SM contra 33% en el grupo con normoviscosidad (NV). El ácido úrico (AU) se observó más elevado en los grupos HV y NV con SM. Se encontró una correlación lineal simple de las concentraciones de glucosa (GLU) y de triglicéridos (TRI) con la VS en el grupo HV sin SM. El análisis de regresión lineal múltiple indicó que la GLU, el AU y la presión sistólica son variables que influyen independientemente con el incremento de la VS en el grupo HV sin SM. Las variables GLU y % de agua influyen en el incremento de la VS en el grupo NV sin SM. El incremento de las concentraciones de glucosa y de ácido úrico son los dos factores que mayormente influyen en la VS en esta población.

The association of blood viscosity (BV) with hypertension and diabetes mellitus type 2 indicates that it should be considered, especially in populations living in mountain chains where the hemoglobin and hematocrit values are higher. In fact, this work analyzed the association of BV with nutritional and biochemical risk factors in the development of cardio metabolic diseases in healthy adults (20-60 years old; 46.39% female and 53.61% male) living in the urban Ecuadorian sierra. The body mass index (BMI) was calculated. The body fat percentage, body water percentage, waist circumference (WC) and blood pressure were measured. Determinations of biochemical and hematological parameters were performed using established methodologies and a validated formula was used to determine the BV. Hyperviscosity (HV) was present in 14.76% of the population: 10.46% men, 4.3% women. In this group, 42.8% showed metabolic syndrome (MS) against 33% in the normoviscosity group (NV). Uric acid (UA) was observed statistically higher in HV and NV with MS groups. A simple positive linear correlation was found between glucose (GLU) and triglycerides (TRI) concentrations and BV in HV without MS group. The multiple linear regression analysis indicated that GLU, UA and systolic pressure influence to increase BV in the HV without MS group. Glucose concentration and percentage of water, independently influence the BV in the NV without MS group. The increase in GLU and UA concentrations are the most influencing factors on BV in this population.

Síndrome de hiperviscosidad en pacientes con mieloma múltiple / Hyperviscosity syndrome in patients with multiple myeloma

Objetivos: el mieloma múltiple es una enfermedad de distribución universal. Se determinaron la frecuencia, las características y el tratamiento del síndrome de hiperviscosidad como complicación de esta enfermedad. Método: se realizó un estudio descriptivo retrospectivo que incluyó a 31 pacientes con el diagnóstico de mieloma múltiple atendidos en el servicio de adultos del Instituto de Hematología e Inmunología desde enero del 2007 a junio del 2011. Resultados: la edad media fue de 61 años con un predominio del sexo masculino y el color de la piel blanca. Los pacientes se presentaron con anemia, eritrosedimentación acelerada, hiperproteinemia, hipoalbuminemia, hipergammaglobulinemia, una infiltración media de la médula ósea por células plasmáticas de 63.2 porciento y una viscosidad sérica media de 2.93. El síndrome de hiperviscosidad se observó en 4 (12.9 porciento) pacientes. Las manifestaciones clínicas principales del síndrome de hiperviscosidad fueron los síntomas generales y los síntomas neurológicos y se presentaron con cifras de viscosidad sérica iguales o superiores a 4.5. La proteína monoclonal identificada como responsable del síndrome de hiperviscosidad fue la IgA y la viscosidad sérica fue proporcional a las concentraciones de la paraproteína (p<0.01). Conclusión: el síndrome de hiperviscosidad se presentó en los pacientes estudiados con similares características a lo reportado por otros autores. La plasmaféresis y la quimioterapia fueron los pilares del tratamiento con resultados satisfactorios

Objectives: multiple myeloma is a disease of worldwide distribution. We determined frequency, characteristics and treatment of hyperviscosity syndrome as a complication of this condition. Method: we conducted a retrospective study involving 31 patients with a diagnosis of multiple myeloma treated at the Adult Hematology Service of the Institute of Hematology and Immunology from January 2007 to June 2011. Results: mean age was 61 years with a male predominance and slight predominance in caucasians. The patients presented with anemia, high erythrosedimentation rate, hyperproteinemia, hypoalbuminemia, hypergammaglobulinemia, a median infiltration of bone marrow by plasma cells of 63.2percent and an average serum viscosity of 2.93. Hyperviscosity syndrome was observed in 4 (12.9 percent) patients. The main clinical manifestations of hyperviscosity syndrome were general symptoms and neurological symptoms and presented with serum viscosity at or above 4.5. The monoclonal protein identified as the responsible of the hyperviscosity syndrome was IgA and viscosity was proportional to the concentrations of the paraprotein (p <0.01). Conclusion: the hyperviscosity syndrome is presented in the studied patients with similar characteristics to those reported by other authors. Plasmapheresis and chemotherapy were the mainstays of treatment with satisfactory results

Utilization of Post-centrifugal Plasma Filtration for Treatment of Hyperviscosity Syndrome due to Waldenstrom's Macroglobulinemia: A Case Report / 대한수혈학회지

Waldenstrom's macroglobulinemia is characterized by overproduction of immunoglobulin M (IgM), which can lead to development of a hyperviscosity syndrome. Plasmapheresis has been used to reduce plasma viscosity and IgM levels. However, plasmapheresis not only removes pathogenic substances but also the normal components in plasma. Post-centrifugal plasma filtration (PCPF) using a filter with an appropriate pore size has been shown to be effective for selective removal of macromolecules in plasma without requiring a replacement fluid. Here, we report on a patient with hyperviscosity syndrome due to Waldenstrom's macroglobulinemia, which was ameliorated by a single treatment of PCPF using an Evaflux 5A filter. After centrifugation, the separated plasma of the patient was subjected to membrane filtration for removal of IgM in the plasma. After PCPF, a 56.5% reduction in the IgM level (from 9,370 mg/dL to 4,080 mg/dL) was achieved, whereas the level of albumin showed a slight decrease, from 2.7 g/dL to 2.4 g/dL (11.1% reduction). The patient's symptoms were relieved and she was discharged on the seventh hospital day.

Clinicopathologic spectrum of Waldenström's macroglobulinemia: A single center experience.

Waldenström's Macroglobulinemia (WM) is a B cell neoplasm characterized by infiltration of the bone marrow by a lymphoplasmacytic infiltrate and an IgM monoclonal gammopathy. We report a 15-year review of patients diagnosed with WM at our center. A total of 18 patients were diagnosed and treated at our center during the study period. Neurological symptoms were seen in almost 95% while B symptoms were present in almost 80% of patients. More than two-thirds of patients were anemic at the time of presentation and more than 90% showed bone marrow infiltration with lymphoplasmacytoid cells. Anemia, B symptoms, splenomegaly and neurological symptoms were the primary reasons in the majority of patients to initiate treatment. Chlorambucil was the primary treatment in more than half the patients followed by CVP. The median overall survival in all patients was 29 months (range 22-81 months). WM is a rare disorder and novel therapeutic modalities need to be identified to improve survival in these patients.

Leucemia mielóide crônica e síndrome de hiper-viscosidade: relato de caso / Chronicle myeloid leukemia and hiperviscosity syndrome: case report

JUSTIFICATIVA E OBJETIVOS: A hiperleucocitose (> 100 x 10(9)/L) em leucemia mielóide crônica não é uma apresentação comum e pode determinar manifestações clínicas de hiper-viscosidade. As perdas auditiva e visual observadas em pacientes com leucemia são consideradas sintomas incomuns, mas fortemente associados à síndrome da hiper-viscosidade. O objetivo deste estudo foi relatar o caso de um paciente que apresentou perda da audição como manifestação inicial de leucemia mielóide crônica e síndrome de hiper-viscosidade e rever aspectos relacionados a seu tratamento em Medicina Intensiva. RELATO DO CASO: Paciente do sexo masculino, 41 anos, com queixa de tontura havia seis meses sem resposta ao tratamento sintomático, foi admitido no serviço de emergência com perda auditiva aguda. Ao exame físico encontrava-se normal, exceto por perda auditiva bilateralmente. Os exames laboratoriais demonstraram leucocitose importante (645.000), com 66,4 por cento de blastos com características mielóides, 13,6 por cento bastões, 15,3 por cento segmentados, 1,4 por cento linfócitos, 3,3 por cento eosinófilos e plaquetas de 225.000. Devido à suspeição de leucemia com risco elevado para síndrome de hiper-viscosidade, o paciente foi admitido para tratamento na unidade de terapia intensiva. Realizado mielograma e biópsia de medula óssea que confirmaram o diagnóstico de leucemia mielóide crônica. Iniciadas hidratação, hidroxiuréia, alopurinol e dexametasona. A leucoaferese foi realizada uma semana após a admissão, quando a contagem leucocitária estava em torno de 488.000. Dez dias após o procedimento, o paciente não apresentou melhora da audição, apesar da leucometria de 10.000. Recebeu alta hospitalar em duas semanas para continuidade do tratamento ambulatorial. CONCLUSÕES: As freqüências das manifestações sensitivas em pacientes com leucemia incluem além das perdas auditiva e visual, vertigem, paralisia facial e infecções. A síndrome de hiper-viscosidade decorrente...

BACKGROUND AND OBJECTIVES: Hyperleukocytosis (> 100 x 10(9)/L) is an uncommon presentation of chronic leukemias and it can present clinical symptoms of hyperviscosity syndrome. Hearing loss and blindness rarely occurs in patients with leukemia; however, it can be strong association with hyper-viscosity syndrome. The purpose of this paper is to report a case of acute hearing loss as the initial manifestation of acute leukemia and hyper-viscosity syndrome and also mainly aspects of the intensive care treatment. CASE REPORT: A 41 year-old, male patient, who has been complaining about dizziness for six months with no response to symptomatic medications, was admitted to the emergency department with acute hearing loss. The physical examination was normal except for a bilateral hearing loss without an apparent cause. Laboratory exams showed total leukocyte: 645.000 with 66.4 percent blasts, hemoglobin: 7.0, hematocrit: 20.5, urea: 94, creatinine: 1.59, K: 5.6, Na: 138, INR: 1.38, TTPa: 0.89, troponin lower than 0.2, CK: 218, CKMB: 50, uric acid: 11.1. After a first hypothesis of leukemia with a high risk of hyper-viscosity complications, the patient was admitted to the Intensive Care Unit for monitoring and treatment. A bone marrow biopsy was performed and than started hidratation, hydroxyurea, allopurinol, dexamethasone. According to hematologists the patient had a chronic myeloid leukemia. Leukopheresis was performed one week after admission when total blood leukocytes were around 488.000. Ten days after the procedure the patient had no improvement of the hearing loss but total leukocytes were 10.100. He was discharge to the ward and 2 weeks later went home to continue ambulatory treatment. CONCLUSIONS: The frequency of sensitive manifestations in patients with leukemia include not only visual and hearing loss but also many others manifestations such as conductive vertigo, facial palsy and infections. Hyperviscosity syndrome due to hyperleukocytosis...

A Plot Double-blind Randomized Aspirin-controlled Study of Xuesaitong Soft Capsule in Patients Suffering from Hyperviscosity Blood Syndrome / 中国中医药信息杂志

0.05). Conclusion XST could be safety and effective to HBS, the mechanism of which is obviously decreasing platelet face activation, inhibiting platelet adhesion and aggregation, decreasing blood viscosity, improving microcirculation and inhibiting thrombosis. XST is much better than Aspirin in improving traditional Chinese syndrom.

Cerebral Infarction in IgG Multiple Myeloma with Hyperviscosity

Cerebral infarction is an uncommon complication in multiple myeloma with hyperviscosity. Serum hyperviscosity may cause a variety of clinical manifestations including bleeding from mucosal membranes, congestive heart failure, retinopathy, and various neurologic deficits. These manifestations have been attributed to the presence of large quantities of asymmetrical molecules of high molecular weight in the serum. We recently experienced a case of multiple myeloma with acute cerebral infarction, which caused by hyperviscosity, as an initial manifestation in IgG multiple myeloma, and reviewed the relevant literature of myeloma presenting with the stroke. A 68-yr-old woman abruptly developed hypesthesia and monoplegia in the left leg. The stroke confirmed by the brain MRI and MR angiography, which revealed acute infarction at the right anterior cerebral artery territory. On admission, routine blood tests showed a slight decrease in hemoglobin and a marked increase in erythrocyte sedimentation rate. Peripheral blood smear, serum protein electrophoresis, serum visocity, and bone marrow aspiration showed that she had IgG multiple myeloma with hyperviscosity. She was treated by chemotherapy with cyclophosphamide and discharged with the improved clinical condition.

A Case of Waldenstrom's Macroglobulinemia Treated with 2-Chlorodeoxyadenosine (Cladribine) / 대한혈액학회지

Waldenstrom's macroglobulinemia is a low- grade lymphoproliferative disorder with monoclonal IgM protein. It is characterized by normocytic, normochromic anemia and lymphoplasmacytic marrow infiltration. Chemotherapy with alkylating agents and steroids has been the standard therapy for patients with symptomatic macroglobulinemia. The purine nucleoside analogues, either alone or in combination with other chemotherapeutic agents are increasingly used, and approximately 40% of patients who have received prior therapy with alkylating agents responded. We experienced a case of Waldenstrom's macroglobulinemia suc-cessfully treated with three courses of cladribine, who had previously received unsuccessful therapy using an alkylating agent, steroid and plasmapheresis. Treatment was well tolerated except for frequent upper respiratory infections with severe pancytopenia. A marked and sustained bone marrow suppression occurred in this patient but resolved in three months without any severe infection.

Sudden Hearing Loss in Chronic Myelogenous Leukemia Implicating Hyperviscosity Syndrome / 대한이비인후과학회지

Sudden sensorineural hearing loss due to the initial manifestation of hematologic disease is very rare. Chronic myelogenous leukemia has been implicated as a causative factor of sudden sensorineural hearing loss. Leukemic infiltration, hemorrhage, infection, and hyperviscosity have been suggested as possible mechanisms in patients with chronic myelogenous leukemia. A 49-year-old male presented unilateral sudden sensorineural hearing loss. The patient was found to have chronic myelogenous leukemia during the work-up for the hearing loss. The WBC count upon admission was 485,100/mm(3). Hemoglobin, hematocrit, and platelet count were within the normal limits. The patient underwent three cycles of leukapheresis and chemotherapy with interferon alpha and hydroxyurea for the treatment of leukemia. The hearing threshold level was 75 dB on admission. It improved to 35 dB when the WBC count fell to 294,000/mm(3), and finally settled at 32 dB two weeks after the termination of chemotherapy when the WBC count was 125,900/mm(3). We present a case of a chronic myelogenous leukemia patient who initially presented with sudden sensorineural hearing loss. We presume that cochlear vessel occlusion as a result of elevated blood viscosity was responsible for this patient's hearing loss. Early onset of sudden deafness in a chronic myelogenous leukemia patient may be due to the hyperviscosity syndrome and be possible to reverse hearing loss through early leukapheresis.

Central Retinal Vein Occlusion in Multiple Myeloma Associated with Hyperviscosity Syndrome

Multiple myeloma is a malignant proliferation of the atypical plasma cells which usually involves antibody synthesis in the immune system. Systemic manifestations include anemia, renal failure, osteoporosis, immune deficiency symptom. Ophthalmolgically this disease involves cornea, conjunctiva, uvea, iris, ciliary body, retinal vessels, extraocular muscles and optic nerve. The authors experienced a case of multiple myeloma with hyperviscosity syndrome who presented with central retinal vein occlusion in both eye.

Hyperviscosity Syndrome in Newborn

We experienced Hyperviscosity syndrome in 5 newborn infants during 6 months period from August 1980 to January 1981. Diagnosis was made on the basis of characteristic clinical symp-toms along with polythemia. The following results were obtained. Sex in 5 affected infants showed male in 2 and female in 3. And gestational age showed preterm in 3 and full term in 2 cases. Predisposing factors were intertwin transfusion in 1, placental insufficiency with maternal to-xemia in 2(one of which was accompained with interwin transfusion) and small for gestational age in 1. Signs and symptoms associated with hyperviscosity syndrome were cyanosis in 3, dyspnea in 2, lethargy in 2, plethora in 1, hypocalcemia in 4, hypoglycemia in 2 and hyperbilirubinemia in 2 cases. Partial exchange transfusion was done in all cases, resulting in improvement of polycythem-ia and clinical condition, except 1 expired case.

Correlation between expression of platelet membrane glycoproteins and hyperviscosity syndrome / 第二军医大学学报

Objective:To study the relationship between hyperviscosity syndrome(HVS) and platelet membrane glycoproteins(GP) sub group changes.Methods: CD62P,CD63,CD31 and CD41 were measured by flow cytometry(FCM). The hemorrheoloic parameters of HVS patients were compared with those of normal aged group and normal young group.Results:(1)The CD62P,CD63 and CD31 of aged and young HVS patients before therapy were obviously higher than those of the normal aged group and normal young group.(2)Combined measurement could improve the detecting positive rate of HVS patients up to 92% 100%, with the sensitivity being 95.3%.(3)Bamyl decreased CD62P,CD63 and CD31,which was obviously correlated with ?b and ?p. Conclusion:The alteration of platelet membrane GP positive expression may be a parameter for early diagnosis and clinical outcome observation.