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Hyperviscosity Syndrome, Emergency Medicine

Matthew B. Mostofi Reviewed 06/2017
 


Basics

Description

  • Hyperviscosity syndrome (HVS) is the clinical consequence of increased blood viscosity.

  • The classic clinical symptoms are the triad of mucosal bleeding, visual disturbances, and neuro...

Diagnosis

Signs and Symptoms

  • Classic triad:

    • Mucosal bleeding

    • Visual disturbances

    • Neurologic

  • Hematologic:

    • Bleeding is the most common manifestation. Mechanism thought to be platelet dysfunction.

    • Epistaxis

    • Ging...

Treatment

Pre-Hospital

IV fluid resuscitation with hemorrhage 

Initial Stabilization/Therapy

  • Rehydrate with 0.9% NS IV fluid.

  • Bleeding or end-organ ischemia may not be controlled by any treatment except p...

Follow-Up

Disposition

Admission Criteria

  • Patients with hyperviscosity and significant symptoms or any evidence of end-organ ischemia or hemorrhage should be admitted for treatment of the underlying hema...

Pearls and Pitfalls

  • Avoid diuretics in patients with HVS because they can increase blood viscosity.

  • The classic triad of symptoms of HVS includes visual disturbances, bleeding, and neurologic manifesta...

Additional Reading

  • Adams  BD, Baker  R, Lopez  JA, et al. Myeloproliferative disorders and the hyperviscosity syndrome. Emerg Med Clin North Am.  2009;27:459–476.

  • Blum  W, Porcu  P. Therapeutic ap...

Codes

ICD9

  • 273.3 Macroglobulinemia

  • 289.0 Polycythemia, secondary

ICD10

  • C88.0 Waldenstrom macroglobulinemia

  • D75.1 Secondary polycythemia

SNOMED

  • 11888009 hyperviscosity syndrome (disorder)

  • 95693006 Hyperviscosi...

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