A Rare Cause of Cardiac Ischemia: Systemic Lupus Erythematosus Presenting as the Hyperviscosity Syndrome
Authors: Frank E. Corrigan
Journal: Annals of Internal Medicine (2010)

Letters21 September 2010A Rare Cause of Cardiac Ischemia: Systemic Lupus Erythematosus Presenting as the Hyperviscosity SyndromeFrank E. Corrigan III, MD, Andrew R. Leventhal, MD, PhD, Sabiha Khan, MD, Shaline Rao, MD, Lisa Christopher-Stine, MD, MPH, and Steven P. Schulman, MDFrank E. Corrigan III, MDFrom Johns Hopkins University School of Medicine, Baltimore, MD 21231.Search for more papers by this author, Andrew R. Leventhal, MD, PhDFrom Johns Hopkins University School of Medicine, Baltimore, MD 21231.Search for more papers by this author, Sabiha Khan, MDFrom Johns Hopkins University School of Medicine, Baltimore, MD 21231.Search for more papers by this author, Shaline Rao, MDFrom Johns Hopkins University School of Medicine, Baltimore, MD 21231.Search for more papers by this author, Lisa Christopher-Stine, MD, MPHFrom Johns Hopkins University School of Medicine, Baltimore, MD 21231.Search for more papers by this author, and Steven P. Schulman, MDFrom Johns Hopkins University School of Medicine, Baltimore, MD 21231.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-153-6-201009210-00023 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail Background: The hyperviscosity syndrome can cause cardiac ischemia by impairing microcirculation. This syndrome with cardiac ischemia can be caused by erythrocytosis, leukocytosis, hypercholesterolemia, or paraproteinemia (1). The hyperviscosity syndrome from paraproteinemia more commonly results from the monoclonal gammopathies of multiple myeloma and Waldenström macroglobulinemia and less commonly from the polyclonal gammopathies of rheumatoid arthritis, the Sjögren syndrome, chronic hepatitis, and some rare lymphoproliferative disorders (2). To the best of our knowledge, only 3 case reports (3–6) have described the hyperviscosity syndrome in systemic lupus erythematosus (SLE), and only 1 of these reports (6) described hyperviscosity as the initial manifestation.Objective: ...References1. Gertz MA, Kyle RA. Hyperviscosity syndrome. J Intensive Care Med. 1995;10:128-41. [PMID: 10155178] CrossrefMedlineGoogle Scholar2. Mehta J, Singhal S. Hyperviscosity syndrome in plasma cell dyscrasias. Semin Thromb Hemost. 2003;29:467-71. [PMID: 14631546] CrossrefMedlineGoogle Scholar3. Crawford J, Cox EB, Cohen HJ. Evaluation of hyperviscosity in monoclonal gammopathies. Am J Med. 1985;79:13-22. [PMID: 4014299] CrossrefMedlineGoogle Scholar4. Dubois EL. Lupus Erythematosus. 1st edition. New York: McGraw-Hill; 1966:332. Google Scholar5. Fukasawa T, Arai T, Naruse T, Maekawa T. Hyperviscosity syndrome in a patient with systemic lupus erythematosus. Am J Med Sci. 1977;273:329-34. [PMID: 868920] CrossrefMedlineGoogle Scholar6. Jara LJ, Capin NR, Lavalle C. Hyperviscosity syndrome as the initial manifestation of systemic lupus erythematosus. J Rheumatol. 1989;16:225-30. [PMID: 2746567] MedlineGoogle Scholar Author, Article, and Disclosure InformationAuthors: Frank E. CorriganIII, MD; Andrew R. Leventhal, MD, PhD; Sabiha Khan, MD; Shaline Rao, MD; Lisa Christopher-Stine, MD, MPH; Steven P. Schulman, MDAffiliations: From Johns Hopkins University School of Medicine, Baltimore, MD 21231.Disclosures: None disclosed. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics Cited byHyperviscosity syndrome in COVID-19 and related vaccines: exploring of uncertaintiesHyperviscosity in primary Sjögren's syndrome: clinical implications 21 September 2010Volume 153, Issue 6 Page: 422-424 Keywords Ankles Antinuclear antibodies Blood plasma Coronary arteries Dyspnea Ischemia Lupus erythematosus Lymphoproliferative disorder Rheumatoid arthritis Troponin ePublished: 21 September 2010 Issue Published: 21 September 2010 Copyright & PermissionsCopyright © 2010 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...