The hyperviscosity syndrome

Abstract

A B S T R A C T The hyperviscosity syndrome is an uncommon complication in IgG myeloma. Its occurrence has been ascribed to the presence in the serum of high molecular weight polymers of the IgG proteins. Three patients with IgG myeloma and the clinical hyperviscosity syndrome were investigated, none of whom had IgG polymers in the serum by analytical ultracentrifugation. Relative serum viscosity in these patients ranged from 10 to 17.4 (normal 1.4-1.8). The total serum proteins ranged from 14 to 19 g/100 ml of which 10 to 17 g/100 ml was IgG globulin. Physicochemical studies of two of the isolated myeloma proteins indicated that they were of normal molecular weight (near 158,000 and 162,-000). Protein Ca had a normal molecular radius (52.2 A) and configuration, (intrinsic viscosity of 5.5 cc/g, frictional ratio 1.48), but

Biotypes of Candida albicans using the API 20C system

“…A total of 130 isolates of C. albicans, comprising 100 oral isolates from Glasgow Dental Hospital, 20 genital isolates from Glasgow Royal Infirmary, and 10 skin isolates from the Department of Dermatology, Glasgow University, were used in this study. All isolates were identified by sugar assimilation and fermentation tests [6] and a germ tube test [7]. They were stored at room temperature under sterile distilled water for up to 5 weeks before the API 20C tests [8].…”

The Hydrodynamic Radii of Macromolecules and Their Effect on Red Blood Cell Aggregation

“…These proteins are present at baseline levels in health, and thus some degree of RBC aggregation is an invariable finding in blood from normal donors, the rate and extent of which varies from individual to individual. In disease, a high ESR is usually associated with an elevated plasma fibrinogen concentration (Hardwicke and Squire, 1952;Lowe, 1988), but occasionally occurs due to increased IgM levels (Waldenstrom's macroglobulinemia) or very high concentrations of IgG or IgA, such as may occur in myeloma (MacKenzie and Babcock, 1975;Preston et al, 1978;Imaizumi and Shiga, 1983). Several other large plasma proteins, such as ceruloplasmin (135,000), haptoglobin (multiple isoforms from 100,000-900,000) and a-2 macroglobulin (725,000) have also been shown to aggregate RBCs or to enhance fibrinogen-mediated aggregation in vitro (Ruhenstroth-Bauer et al, 1962;Schmid-Schönbein et al, 1973;Weng et al, 1996).…”

Rare Lymphomas

“…Increased plasma viscosity may also contribute to inappropriately low erythropoietin production, which is the major reason for anemia in these patients (Singh et al 1993 ). Symptoms usually occur when the monoclonal IgM concentration exceeds 50 g/L or when serum viscosity is >4.0 centipoises (cp) (corresponding to a serum IgM level of at least 30 g/L), but there is a great individual variability, with some patients showing no evidence of hyperviscosity even at 10 cp (Mackenzie and Babcock 1975 ). 16.1 ).…”