Hyperviscosity syndrome in IgE myeloma.

Abstract

impair mineralisation may limit the hypocalcaemic effect. The ease with which diphosphonates may be used and the absence of appreciable side effects4 make this an attractive treatment not only for immobilisation hypercalcaemia but also for the more commonly observed hypercalciuria and bone loss.We thank Gentili for the clodronate used in these patients.

Ixazomib Treatment of IgA Multiple Myeloma With Hyperviscosity Syndrome

“…16 More recently, ixazomib, a second-generation orally available proteasome inhibitor, has been approved for the treatment of relapsed or refractory MM. 17 24 1974 26 1984 It has not yet been confirmed in clinical studies whether control of hyperviscosity prolongs overall survival or only reduces the morbidity that results from the underlying malignancy. Furthermore, no clinical trials have been performed to determine the effectiveness of systemic therapy for HVS in the context of underlying MM.…”

“…Although rare, HVS has been reported previously in patients with MM. [18][19][20][21][22][23][24][25][26][27][28][29][30][31] Because previous reports of HVS dated back > 50 years 18 and owing to its low incidence, the clinical characteristics of HVS remain largely unknown. A total of 19 additional cases of HVS in association with MM reported between 1967 and 2015 were identified.…”

“…The mean serum viscosity measured at 37 C (n ¼ 16) was 6.1 (range, [3][4][5][6][7][8][9][10][11][12][13][14][15][16][17][18]. In 2 patients, 19,22 the serum viscosity was measured at 22 C and 13 C, and in 1 report, 26 the viscosity level was not specified. Of the 20 patients, 17 (85%) had received plasma exchange therapy to lower the serum viscosity quickly.…”

Hyperviscosity Syndrome

“…Treatment of the serum with 2-mercaptoethanol decreased this large protein to a molecular mass of less than 14 kDa. Two patients with hyperviscosity syndrome due to IgE myeloma have been reported [75,76]. Both patients had a circulating cryoglobulin that contributed to the syndrome.…”

Low IgE monoclonal gammopathy level in serum highlights 20‐yr survival in a case of IgE multiple myeloma

“…As with other isotypes of myeloma, IgE myeloma has clinical features of bone pain, osteolytic bone lesions, hypercalcemia, elevated erythrocyte sedimentation rate, infections, weakness, fatigue, and weight loss (4, 10), but a higher rate of plasma cell leukemia, anemia, hepatosplenomegaly, osteosclerotic bone lesions, renal insufficiency, respiratory infections, and Herpes Zoster (1, 4, 7, 8, 11, 12). It has also been reported in association with amyloidosis (1), cryoglobulinemia, and hyperviscosity syndrome (13). Most patients with IgE myeloma have more severe disease with shorter survival times than IgG and IgA myeloma (1, 7, 8).…”