As plasmapheresis removes the circulating paraproteins, the serum viscosity decreases and symptoms improve. Although symptoms of CHF from hyperviscosity may not respond to standard therapies, plasmapheresis reverses these symptoms. While arranging for plasmapheresis, treat hemorrhage, CHF, and metabolic imbalances with standard therapies. A hematologist should be consulted to arrange plasmapheresis. Supportive care should be initiated for the complications of hyperviscosity syndrome pending definitive therapy.
Care includes support for blood loss, central nervous system disorders, and cardiovascular effects.
These depend upon the underlying cause of the hyperviscosity. For example, multiple myeloma continues to have a poor long-term prognosis. The diseases leading to hyperviscosity are chronic, and this condition may recur. Patients should be educated about early signs and symptoms. Hyperviscosity syndromes associated with immunoglobulin abnormalities.