![]() Serum viscosity and electrophoresis are recommended before and after plasmapheresis in order to correlate viscosity and M-spike with patient symptoms. Hyperviscosity syndrome can also occur in multiple myeloma patients.īecause the ability of a monoclonal protein to cause hyperviscosity is affected by its concentration, molecular weight, and aggregation, sera with concentrations of monoclonal IgM greater than 4 g/dL, IgA greater than 5 g/dL, or IgG greater than 6 g/dL should be tested for hyperviscosity. The most common cause of serum hyperviscosity is the presence of large concentrations of IgM monoclonal proteins, and Waldenstrom macroglobulinemia accounts for 80% to 90% of hyperviscosity cases. ![]() Funduscopic examination reveals dilation of retinal veins and flame shaped retinal hemorrhages. ![]() Hyperviscosity may be manifested by nasal bleeding, blurred vision, headaches, dizziness, nystagmus, deafness, diplopia, ataxia, paresthesias, or congestive heart failure. Viscosity is the property of fluids to resist flow. ![]()
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