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August 26, 1974

Plasmapheresis in Hyperviscosity Syndrome— A Better Way?

Author Affiliations

From the Department of Oncology, Good Samaritan Hospital, Cincinnati.

JAMA. 1974;229(9):1211. doi:10.1001/jama.1974.03230470053027

PLASMAPHERESIS has been accepted as an effective treatment for the immediate control of hyperviscosity syndrome. However, routine methods of blood withdrawal in this entity are fraught with many technical difficulties. Recently, we treated a patient with multiple myeloma and hyperviscosity syndrome who demonstrated many of the clinical problems associated with plasmapheresis and suggest a method by which these problems can be circumvented.

Report of Case  A 66-year-old white man was admitted to the hospital for evaluation of his increasing confusion. He had been transferred from an outlying hospital where he had been admitted with anemia and upper respiratory tract infection. There was no history of bleeding, visual symptoms, or dyspnea. On admission, the patient was very confused. Temperature was 38.3 C (101 F). Pertinent physical findings were distended retinal veins, S4 gallop, and diffuse pulmonary rhonchi. Drawing blood was extremely difficult because of rapid clotting. A bone marrow examination