Therapeutic plasma exchange for hyperviscosity syndrome in IgA multiple myeloma

Nalan Yurtsever; Thomas C Binns; Jeanne E Hendrickson; Christopher A Tormey; Edward S Lee

doi:10.1093/labmed/lmae054

Therapeutic plasma exchange for hyperviscosity syndrome in IgA multiple myeloma

Lab Med. 2024 Jul 22:lmae054. doi: 10.1093/labmed/lmae054. Online ahead of print.

Authors

Nalan Yurtsever¹, Thomas C Binns¹, Jeanne E Hendrickson², Christopher A Tormey¹, Edward S Lee¹

Affiliations

¹ Department of Laboratory Medicine, Yale School of Medicine, New Haven, CT, US.
² Department of Pathology and Laboratory Medicine, Emory University School of Medicine and Children's Healthcare of Atlanta, Atlanta, GA, US.

PMID: 39038224
DOI: 10.1093/labmed/lmae054

Abstract

Hyperviscosity syndrome (HVS) is defined as the symptomatic presentation of increased blood thickness due to various clinical conditions such as hypergammaglobulinemia. HVS secondary to immunoglobulin (Ig)A multiple myeloma has been infrequently reported. Although the efficiency of IgM or IgG removal by therapeutic plasma exchange (TPE) is well described, the efficiency of IgA removal by TPE is not as well known. Here, we describe a case of HVS due to IgA myeloma in a patient who received 2 TPE treatments, with subsequent symptomatic improvement as well as decrease in IgA and viscosity levels.

Keywords: IgA; IgG; hyperviscosity; plasma exchange; plasmapheresis.

© The Author(s) 2024. Published by Oxford University Press on behalf of American Society for Clinical Pathology. All rights reserved. For commercial re-use, please contact [email protected] for reprints and translation rights for reprints. All other permissions can be obtained through our RightsLink service via the Permissions link on the article page on our site—for further information please contact [email protected].