Hyperviscosity syndrome - Revision history

Elcatracho: /* Management */

2021-02-12T15:09:39Z

Management

← Older revision		Revision as of 15:09, 12 February 2021
Line 51:		Line 51:
	**Plateletpheresis		**Plateletpheresis
	**Consider [[ASA]]		**Consider [[ASA]]
	*Polycythemia		*[[Polycythemia vera\|Polycythemia]]
	**Phlebotomy		**Phlebotomy
	*If pheresis is not unavailable, phlebotomize 2-3 units, give 2-3 L IVF		*If pheresis is not unavailable, phlebotomize 2-3 units, give 2-3 L IVF

Elcatracho: /* Management */

2021-01-18T21:13:42Z

Management

← Older revision		Revision as of 21:13, 18 January 2021
Line 44:		Line 44:
	*ABCs		*ABCs
	*[[IVF]], supportive care		*[[IVF]], supportive care
	*Ig mediated		*Ig mediated/Dysproteinemia
	**[[Plasmapheresis]]		**[[Plasmapheresis]]
	*Leukostasis		*Leukostasis

ClaireLewis at 01:02, 1 October 2019

2019-10-01T01:02:33Z

← Older revision		Revision as of 01:02, 1 October 2019
Line 7:		Line 7:
	==Clinical Features==		==Clinical Features==
	*General: [[fever]], [[fatigue]]		*General: [[fever]], [[fatigue]]
	*CNS: [[headache]], blurred vision, [[altered mental status]], [[focal neurologic deficits]]		*CNS: [[headache]], [[blurred vision]], [[altered mental status]], [[focal neurologic deficits]]
	*Pulm: [[dyspnea]], [[hypoxia]]		*Pulm: [[dyspnea]], [[hypoxia]]
	*Cardiac: [[chest pain]], [[CHF]]		*Cardiac: [[chest pain]], [[CHF]]
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	*CBC, coags, type and screen, chem 10		*CBC, coags, type and screen, chem 10
	*[[Urinalysis]]		*[[Urinalysis]]
	*CT head if neuro symptoms		*[[CT head]] if neuro symptoms
	*[[CXR]]		*[[CXR]]
	*Consider initiating inpatient testing with: Total protein, albumin, SPEP, UPEP, IgA, IgG, IgM		*Consider initiating inpatient testing with: Total protein, albumin, SPEP, UPEP, IgA, IgG, IgM
	*Note: ~~ABGs~~ might have SaO2 vs. SpO2 discrepancies		*Note: [[ABG]]s might have SaO2 vs. SpO2 discrepancies
	**Causing spurious hypoxemia on ABG, with low PaO2 (as opposed to [[dyshemoglobinemia]])		**Causing spurious hypoxemia on ABG, with low PaO2 (as opposed to [[dyshemoglobinemia]])
	**Due to "leukocyte larceny," "platelet larceny"<ref>Mehta A, Lichtin AE, Vigg A, Parambil JG. Platelet larceny: spurious hypoxaemia due to extreme thrombocytosis. Eur Respir J. 2008 Feb;31(2):469-72.</ref><ref>Sacchetti A, Grynn J, Pope A, Vasso S. Leukocyte larceny: spurious hypoxemia confirmed with pulse oximetry. J Emerg Med. 1990 Sep-Oct;8(5):567-9.</ref><ref>Lele AV, Mirski MA, Stevens RD. Spurious hypoxemia. Crit Care Med. 2005 Aug;33(8):1854-6.</ref>		**Due to "leukocyte larceny," "platelet larceny"<ref>Mehta A, Lichtin AE, Vigg A, Parambil JG. Platelet larceny: spurious hypoxaemia due to extreme thrombocytosis. Eur Respir J. 2008 Feb;31(2):469-72.</ref><ref>Sacchetti A, Grynn J, Pope A, Vasso S. Leukocyte larceny: spurious hypoxemia confirmed with pulse oximetry. J Emerg Med. 1990 Sep-Oct;8(5):567-9.</ref><ref>Lele AV, Mirski MA, Stevens RD. Spurious hypoxemia. Crit Care Med. 2005 Aug;33(8):1854-6.</ref>
Line 43:		Line 43:
	==Management==		==Management==
	*ABCs		*ABCs
	*IVF, supportive care		*[[IVF]], supportive care
	*Ig mediated		*Ig mediated
	**[[Plasmapheresis]]		**[[Plasmapheresis]]
	*Leukostasis		*Leukostasis
	**~~Leukopheresis~~		**Leukapheresis
	*Thrombocytosis		*Thrombocytosis
	**Plateletpheresis		**Plateletpheresis

Kxl328: /* Background */

2018-10-07T00:06:08Z

Background

← Older revision		Revision as of 00:06, 7 October 2018
Line 1:		Line 1:
	==Background==		==Background==
	*Increased serum viscosity due to:		*Increased serum viscosity due to:
	*Increased blood products ([[polycythemia]], thrombocytosis, [[leukemia]])		**Increased blood products ([[polycythemia]], thrombocytosis, [[leukemia]])
	*Immunoglobulins (Waldenstrom's, IgA myeloma, [[multiple myeloma]])		**Immunoglobulins (Waldenstrom's, IgA myeloma, [[multiple myeloma]])
	*Symptoms arise from poor capillary flow and organ congestion		*Symptoms arise from poor capillary flow and organ congestion

Kxl328: /* Background */

2018-10-07T00:05:54Z

Background

← Older revision		Revision as of 00:05, 7 October 2018
Line 1:		Line 1:
	==Background==		==Background==
	*Increased serum viscosity due to:		*Increased serum viscosity due to:
	*#Increased blood products ([[polycythemia]], thrombocytosis, [[leukemia]])		*Increased blood products ([[polycythemia]], thrombocytosis, [[leukemia]])
	*#Immunoglobulins (Waldenstrom's, IgA myeloma, [[multiple myeloma]])		*Immunoglobulins (Waldenstrom's, IgA myeloma, [[multiple myeloma]])
	*Symptoms arise from poor capillary flow and organ congestion		*Symptoms arise from poor capillary flow and organ congestion

Neil.m.young: Reverted edits by Neil.m.young (talk) to last revision by ClaireLewis

2017-03-01T16:40:53Z

Reverted edits by Neil.m.young (talk) to last revision by ClaireLewis

← Older revision		Revision as of 16:40, 1 March 2017
Line 53:		Line 53:
	*Polycythemia		*Polycythemia
	**Phlebotomy		**Phlebotomy
	*If pheresis is not unavailable, phlebotomize 2-3 units, give 2-3 ~~left~~ IVF		*If pheresis is not unavailable, phlebotomize 2-3 units, give 2-3 L IVF

	==Disposition==		==Disposition==

Neil.m.young: Text replacement - " L " to " left "

2017-02-27T22:28:00Z

Text replacement - " L " to " left "

← Older revision		Revision as of 22:28, 27 February 2017
Line 53:		Line 53:
	*Polycythemia		*Polycythemia
	**Phlebotomy		**Phlebotomy
	*If pheresis is not unavailable, phlebotomize 2-3 units, give 2-3 L IVF		*If pheresis is not unavailable, phlebotomize 2-3 units, give 2-3 left IVF

	==Disposition==		==Disposition==

ClaireLewis at 21:21, 22 December 2016

2016-12-22T21:21:56Z

← Older revision		Revision as of 21:21, 22 December 2016
Line 1:		Line 1:
	==Background==		==Background==
	*Increased serum viscosity due to:		*Increased serum viscosity due to:
	*#Increased blood products (polycythemia, thrombocytosis. leukemia)		*#Increased blood products ([[polycythemia]], thrombocytosis, [[leukemia]])
	*#Immunoglobulins (Waldenstrom's, IgA myeloma, multiple myeloma)		*#Immunoglobulins (Waldenstrom's, IgA myeloma, [[multiple myeloma]])
	*Symptoms arise from poor capillary flow and organ congestion		*Symptoms arise from poor capillary flow and organ congestion

	==Clinical Features==		==Clinical Features==
	*General: [[fever]], [[fatigue]]		*General: [[fever]], [[fatigue]]
	*CNS: [[headache]], [[blurred vision]], [[altered mental status]], [[focal neurologic deficits]]		*CNS: [[headache]], blurred vision, [[altered mental status]], [[focal neurologic deficits]]
	*Pulm: [[dyspnea]], [[hypoxia]]		*Pulm: [[dyspnea]], [[hypoxia]]
	*Cardiac: [[chest pain]], [[CHF]]		*Cardiac: [[chest pain]], [[CHF]]
	*~~Hem~~: mucosal bleeding		*Heme: mucosal bleeding

	==Differential Diagnosis==		==Differential Diagnosis==
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	==Evaluation==		==Evaluation==
	===Workup===		===Workup===
	*CBC		*CBC, coags, type and screen, chem 10
	*Chem 10
	*Coags
	*Type and screen
	*[[Urinalysis]]		*[[Urinalysis]]
	*CT ~~brain~~ if neuro symptoms		*CT head if neuro symptoms
	*[[CXR]]		*[[CXR]]
	*Consider initiating inpatient testing with: Total protein, albumin, SPEP, UPEP, IgA, IgG, IgM		*Consider initiating inpatient testing with: Total protein, albumin, SPEP, UPEP, IgA, IgG, IgM
Line 46:		Line 43:
	==Management==		==Management==
	*ABCs		*ABCs
	*IVF ~~and~~ supportive care		*IVF, supportive care
	*Ig mediated		*Ig mediated
	**~~Plasmapharesis~~		**[[Plasmapheresis]]
	*Leukostasis		*Leukostasis
	**Leukopheresis		**Leukopheresis
	*Thrombocytosis		*Thrombocytosis
	**Plateletpheresis		**Plateletpheresis
	**Consider ASA		**Consider [[ASA]]
	*Polycythemia		*Polycythemia
	**Phlebotomy		**Phlebotomy

Rossdonaldson1: Text replacement - "UA" to "Urinalysis"

2016-10-02T15:16:53Z

Text replacement - "*UA" to "*Urinalysis"

← Older revision		Revision as of 15:16, 2 October 2016
Line 28:		Line 28:
	*Coags		*Coags
	*Type and screen		*Type and screen
	*UA		*[[Urinalysis]]
	*CT brain if neuro symptoms		*CT brain if neuro symptoms
	*[[CXR]]		*[[CXR]]

Rossdonaldson1: /* Clinical Features */

2016-09-24T06:10:22Z

Clinical Features

← Older revision		Revision as of 06:10, 24 September 2016
Line 6:		Line 6:

	==Clinical Features==		==Clinical Features==
	*~~Gen~~: fever, fatigue		*General: [[fever]], [[fatigue]]
	*CNS: headache, blurred vision, altered mental status, focal ~~neuro~~ deficits		*CNS: [[headache]], [[blurred vision]], [[altered mental status]], [[focal neurologic deficits]]
	*Pulm: dyspnea, hypoxia		*Pulm: [[dyspnea]], [[hypoxia]]
	*Cardiac: chest pain, CHF		*Cardiac: [[chest pain]], [[CHF]]
	*Hem: mucosal bleeding		*Hem: mucosal bleeding

Hyperviscosity syndrome - Revision history

Elcatracho: /* Management */

Elcatracho: /* Management */

ClaireLewis at 01:02, 1 October 2019

Kxl328: /* Background */

Kxl328: /* Background */

Neil.m.young: Reverted edits by Neil.m.young (talk) to last revision by ClaireLewis

Neil.m.young: Text replacement - " L " to " left "

ClaireLewis at 21:21, 22 December 2016

Rossdonaldson1: Text replacement - "*UA" to "*Urinalysis"

Rossdonaldson1: /* Clinical Features */

Rossdonaldson1: Text replacement - "UA" to "Urinalysis"