Dumas G, Merceron S, Zafrani L, Canet E, Lemiale V, Kouatchet A, Azoulay E
Service de réanimation médicale, hôpital Saint-Louis, AP-HP, 1, avenue Claude-Vellefaux, 75010 Paris, France.
Service de réanimation médicale, CHU d'Angers, 4, rue Larrey, 49100 Angers, France.
Rev Med Interne. 2015 Sep;36(9):588-95. doi: 10.1016/j.revmed.2015.02.005. Epub 2015 Mar 13.
Hyperviscosity syndrome is a life-threatening complication. Clinical manifestations include neurological impairment, visual disturbance and bleeding. Measurement of plasma or serum viscosity by a viscometer assesses the diagnosis. Funduscopic examination is a key exam because abnormalities are well-correlated with abnormal plasma viscosity. Etiologies are various but symptomatic hyperviscosity is more common in Waldenström's macroglobulinemia and multiple myeloma. Prompt treatment is needed: treatment of the underlying disease should be considered, but generally not sufficient. Symptomatic measures aim to not exacerbate blood viscosity while urgent plasmapheresis effectively reduces the paraprotein concentration and relieves symptoms.
高黏滞血症是一种危及生命的并发症。临床表现包括神经功能损害、视觉障碍和出血。通过粘度计测量血浆或血清粘度有助于诊断。眼底检查是一项关键检查,因为异常情况与血浆粘度异常密切相关。病因多种多样,但症状性高黏滞血症在华氏巨球蛋白血症和多发性骨髓瘤中更为常见。需要及时治疗:应考虑对基础疾病进行治疗,但通常并不充分。对症措施旨在不加重血液粘度,而紧急血浆置换可有效降低副蛋白浓度并缓解症状。