Dementia reversible by plasmapheresis in multiple myeloma

Area of Science:

• Neurology
• Hematology
• Internal Medicine

Background:

• Hyperviscosity syndrome is an uncommon condition that can manifest with neurological symptoms, including dementia.
• Cerebral hypoxia secondary to hyperviscosity is a known, though rarely identified, cause of cognitive impairment.
• IgG-κ myeloma is a plasma cell disorder that can lead to hyperviscosity.

Purpose of the Study:

• To report a case of moderate dementia as the sole presenting symptom of hyperviscosity syndrome.
• To highlight the diagnostic challenge of recognizing hyperviscosity syndrome when dementia is the only manifestation.
• To demonstrate the efficacy of plasmapheresis in treating cognitive decline associated with hyperviscosity syndrome.

Main Methods:

• Case report of a patient with IgG-κ myeloma presenting with moderate dementia.
• Diagnostic workup including assessment for hyperviscosity syndrome.
• Therapeutic intervention with plasmapheresis.

Main Results:

• The patient presented with moderate dementia as the primary and seemingly only manifestation of disease.
• Hyperviscosity syndrome was diagnosed, secondary to IgG-κ myeloma.
• Plasmapheresis led to a dramatic improvement in the patient's dementia.

Conclusions:

• Dementia can be the sole presenting symptom of hyperviscosity syndrome.
• Early recognition and treatment of hyperviscosity syndrome are crucial for managing associated neurological deficits.
• Plasmapheresis is an effective treatment modality for dementia caused by hyperviscosity syndrome.