Título / Title

SYNDROME OR STATE OF HYPERVISCOSITY SECUNDARY A MULTIPLE MYELOMA

Introdução / Purpose

The syndrome or state of hyperviscosity is a clinical condition not common at ophthalmologic first aid, which is associated to neoplasms such as multiple myeloma – that corresponds to 10% of hematological neoplasms. This syndrome manifests systemically by the increase of blood viscosity and, in some cases, presenting fundoscopic changes such papilla edema, tortuosity, vessel engorgement and at retinal hemorrhages.
Treatment directs for the base illness and counts by auxiliary measures hydration and plasmapheresis, being the last one the treatment of choice.

Material e Método / Methods

Case Report off a patient, V.C.S, 49 years old, male, was admitted at the emergency room, in our service at Cema Hospital – São Paulo – after presenting, 3 weeks early, a condition of low visual acuity in both eyes. He presented comorbidities such as: hypertension, diabetes and multiple myeloma

Resultados / Results

Patient died within few days due to advanced cancer and patient debilitation.

Discussão e Conclusões / Conclusion

This case corresponds to a not common picture at a ophthalmology first aid and in between the retinal diagnoses because of low visual acuity evidenced at the retinal mapping, when is presented hyperviscosity retinopathy, because is expected as a differential diagnoses: retinal central venous occlusion, waldenstrom macroglobulinemia and multiple myeloma.
The syndrome diagnoses and the patient accompaniment can happen just after clinical manifestation, which can vary from kidney problems, hematological disorders, cardiovascular problems, neurological symptoms, such as convulsion and lethargy, besides visual alteration like papilla edema, dilatation, vessel engorgement and the hemorrhages in candle flame.
The main treatment of hyperviscosity syndrome secundary to multiple myeloma consists in plasmapheresis. We have associated measures and of support vigorous hydration, use of antibiotics, blood transfusion and use of corticoids and immunosuppressants.

Palavras Chave

hyperviscosity , neoplasms ,multiple myeloma