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Serum Viscosity and Hyperviscosity Syndrome in IgG Multiple Myeloma: Report on 10 Patients and a Review of the Literature

W. PRUZANSKl, M.D., F.R.C.P. (C), F.A.C.P.; and J. G. WATT, M.D., F.R.C.P. (C), F.A.C.P.
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Supported in part by a grant from the Ontario Cancer Treatment and Research Foundation, Ontario, Canada.

▸Requests for reprints should be addressed to W. Pruzanski, M.D., Wellesley Hospital, 160 Wellesley St. East, Toronto 5, Ontario, Canada.

Toronto, Ontario, Canada

Ann Intern Med. 1972;77(6):853-860. doi:10.7326/0003-4819-77-6-853
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Ten patients with IgG multiple myeloma and hyperviscosity were investigated. They represented 4.2% of 238 patients with IgG myeloma and 22% of 46 patients with IgG M components present in the serum in concentration above 5.0 g/100 ml. The severity of the hyperviscosity syndrome was not directly related to the serum viscosity; each patient responded individually to hyperviscosity. No absolute correlation was found between the viscosities measured at the low and the high shear rate and the absolute viscosity taken at 37 °C or the relative viscosity taken at 22 °C. There was no relationship of the light chain type of M component to the hyperviscosity. Remarkable correlation was noted between the positivity of Sia test and the hyperviscosity properties of the serums. Sia precipitates were composed of an IgG M component. Cryoprecipitation and a tendency to form high-molecular-weight aggregates have also been noted among IgG M components causing hyperviscosity.





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