Hyperviscosity syndrome

At the Hyperviscosity syndrome it is a clinical symptom complex. In many cases, the syndrome is simply referred to as HVS designated. The cause of the hyperviscosity syndrome lies in an increased concentration of so-called paraproteins in the plasma of the blood. As a result of the increased viscosity, the blood's ability to flow decreases, which can lead to a multitude of complications in the organism.

What is hyperviscosity syndrome?

The main feature of the Hyperviscosity syndrome consists in an increased viscosity or viscosity of the blood. Basically, the viscosity of the blood depends on the concentration of the paraproteins that are dissolved in the plasma. Their chemical and physical properties have a direct effect on the viscosity and thus the fluidity of the blood.

The hyperviscosity syndrome as a result of increased paraproteins in the plasma occurs in a number of malignancies. These include, for example, Waldenström's disease and so-called multiple myeloma. In addition, the hyperviscosity syndrome also appears in some benign diseases, such as rheumatoid arthritis, Felty syndrome and lupus erythematosus.

The hyperviscosity syndrome occurs in multiple myeloma in almost ten percent of all cases and in Waldenström's disease in up to 30 percent of all cases.

causes

In order to understand the causes of hyperviscosity syndrome, some basics about blood viscosity are important. In principle, this depends on a large number of different factors. The most influential are the plasma viscosity, the hematocrit and the deformability of the red blood cells. Deviations in one or more of these factors from the normal values ​​lead to changes in blood viscosity.

For example, plasma viscosity is increased in multiple myeloma. The detection of atypical blood proteins or paraproteins is typical for multiple myeloma. Possible symptoms include spontaneous fractures, renal insufficiency in the presence of a plasmacytoma kidney, and hyperviscosity syndrome.

This occurs more frequently with cerebral circulatory disorders and neurological failures. The hematocrit is increased, for example, in so-called desiccosis and affects the blood viscosity. Desiccosis describes the dehydration of the body. It occurs when the fluid intake is too low compared to the excretion. The deformability of the red blood cells or erythrocytes is increased in the context of sickle cell anemia.

This is understood to be a form of anemia due to sickle-shaped red blood cells. A special pathological hemoglobin causes the red blood cells to deform when the oxygen saturation is low. As a result, severe circulatory disorders occur in organs and body tissue.

Sickle cell anemia can be fatal. If the blood viscosity is increased, in most cases circulatory disorders occur in the so-called end flow areas of the vascular system. As a result, tissues and organs are less supplied with blood, whereby the circulatory disorders depend on the severity of the increase in viscosity.

Symptoms, ailments & signs

Many different symptoms and complaints are possible in the context of hyperviscosity syndrome, which differ from patient to patient. They depend on the type of viscosity increase and the severity of the disease. Some organs, such as the heart, kidneys and brain, are very sensitive to circulatory disorders.

Functional restrictions of the corresponding organs are often the result. In the early stages, therefore, dyspnoea, neurological failures, kidney and heart failure often occur. Typical marks, the so-called livedo reticularis, can also appear on the skin.As a result of the slowed blood flow, the risk of thrombosis and embolism increases.

The likelihood of complications increases, particularly in bedridden patients. In general, many affected patients complain of a general feeling of weakness, loss of appetite, tiredness and shortness of breath. Anemia can develop from bleeding from the mucous membrane and nose as the platelet function is impaired. Nosebleeds and bleeding of the oral mucosa occur as a result of the impaired blood clotting.

The bleeding time after injuries is also longer than usual. Typical symptoms of the central nervous system are dizziness and headaches, drowsiness and even coma, and epileptic fits. Sensitivity disorders are also possible. Sometimes those affected complain of impaired vision. Hearing loss can occur as part of the hyperviscosity syndrome. Angina pectoris sometimes develops in the heart.

Diagnosis & course of disease

Hyperviscosity syndrome is usually diagnosed with a blood test. First the treating specialist discusses the individual medical history with the patient. Symptoms that occur provide information about the disease and its severity.

The increased concentration of paraproteins can be demonstrated with a so-called serum electrophoresis. The blood viscosity is measured with a capillary viscometer and shows the increased values. Another indication of the hyperviscosity syndrome can also be complications during blood collection, such as blocked cannulas.

Complications

The hyperviscosity syndrome leads to numerous complaints and complications in the body. The organs and regions in the body that are supplied with blood are particularly affected. This can lead to shortness of breath, which leads to a panic attack in many patients.

Furthermore, there are also heart problems, so that in the worst case the patient can also die of heart failure. The kidneys can also be affected by insufficiency, in which the person concerned is dependent on dialysis or a donor kidney. The quality of life and life expectancy of the patient are reduced by hyperviscosity syndrome.

The person concerned has a general feeling of illness and feels weak. There is tiredness and loss of appetite. Dizziness and nausea also occur, and it is not uncommon for those affected to faint. The sensitivity of the body is also limited and loss of vision or hearing can occur. In the worst case, the patient falls into a coma.

Since hyperviscosity syndrome is not an independent disease, the treatment is usually carried out causally. Acute emergencies can be resolved with the help of medication. The complications usually depend on the underlying disease of hyperviscosity syndrome.

When should you go to the doctor?

People who suffer from circulatory disorders should always consult a doctor. If there are more and more cold limbs, numbness of the skin, sensitivity disorders or a feeling of pressure in the vessels, a doctor's visit is necessary to clarify the symptoms. In the event of digestive disorders, abnormalities when using the toilet or pain in the upper body, a doctor should be consulted.

If there are breathing restrictions, shortness of breath or anxiety, the person concerned needs help and support. An irregular heartbeat, changes in blood pressure, or dizziness should be examined and treated. If you feel generally ill, feel unwell, walk unsteadily or have reduced drive, a visit to a doctor is recommended.

If everyday duties can no longer be performed as usual or if the normal level of performance drops, a doctor should be consulted. If there are changes in the skin, discoloration or blemishes, these should be presented to a doctor. Good medical care is necessary in the event of involuntary itching or open wounds.

There is a threat of further illnesses as pathogens can enter the organism. In case of internal weakness, tiredness and exhaustion, a doctor should be consulted. If the complaints persist for a long time, this is considered unusual and requires treatment. Insomnia, decreased muscle strength or irregular muscle activity should be examined and treated.

Doctors & therapists in your area

Treatment & Therapy

Therapy for hyperviscosity syndrome is always based on the cause. In acute cases it is necessary to thin the blood with infusions. The further treatment of the viscosity symptoms usually takes place symptomatically, for example by plasma exchange. A cell separator separates the plasma from the cellular components.

However, plasma exchange is only recommended in emergencies, such as epileptic seizures, coma or heart failure. To cure hyperviscosity syndrome, the underlying disease must be treated. The prognosis of the disease also depends on this.

prevention

There are no concrete measures to prevent hyperviscosity syndrome. It is all the more important to consult a specialist at the first signs of the disease. Regular blood tests also help identify the disease early on.

Aftercare

There are no specific preventive and aftercare measures for the hyperviscosity syndrome. That is why regular medical check-ups are extremely important. They are designed to help relieve symptoms. This also reduces the risk of heart problems. Medical treatment is essential as there is no self-help in the context of aftercare.

Medical therapy is the only way to avoid serious problems that may lead to patient death. The earlier the diagnosis and treatment, the more likely it will be a positive outcome. In order to prevent the syndrome from breaking out, the endangered persons can avoid threatening stressful situations.

Otherwise, there is a risk of passing out. Then those present have to call an emergency doctor immediately and bring the patient into a stable lateral position. The involvement of family members is an important point in this context, as this is how they can help in an emergency.

The condition can cause loss of appetite, which often leads to a loss of weight and deficiency symptoms. A consistent and regular diet with balanced meals stabilizes health and counteracts excessive weight loss. The appropriate recommendations of the doctor or a fixed meal plan can help.

You can do that yourself

Unfortunately, in most cases of hyperviscosity syndrome, the patient has no options for self-help. For this reason, the syndrome must always be treated by a doctor. This avoids serious complications which, in the worst case, can lead to the patient's death.

In particular, early diagnosis and treatment has a very positive effect on the further course of the disease. If the patient loses consciousness and faints due to the syndrome, an emergency doctor must be called. Until the emergency doctor arrives, it is important to ensure a stable lateral position and stable breathing. Furthermore, the person concerned should avoid stressful situations. Since the hyperviscosity syndrome can also lead to a loss of appetite, the person affected should ensure a regular and above all healthy diet. This can prevent deficiency symptoms and weight loss.

During surgical interventions, the patient should inform the attending physician about the disease in order to avoid excessive bleeding and associated complications. Regular examinations and checks by the doctor can also alleviate the symptoms of the syndrome and prevent possible heart problems. The syndrome itself cannot be prevented.