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Published on: July 31, 2016
Resolution of high output pulmonary edema due to hyperviscosity with plasma exchange in a patient with multiple
Charanpreet Singh1, Deepesh Lad1, Arihant Jain1
1Department of Internal Medicine, Clinical Hematology and Bone Marrow Transplant Unit, Postgraduate Institute of Medical Education and Research, Chandigarh, India.
Abstract:
Symptomatic hyperviscosity is an oncologic emergency which is suspected when patients with certain hematogical malignancies present with neurological symptoms. Hyperviscosity syndrome is a rare clinical manifestation in multiple myeloma. We describe a case of a 61 year old lady who developed pulmonary infiltrates after being diagnosed with multiple myeloma. Treated as an infection with antibiotics and intravenous immunoglobulin, she had neurological symptoms which suggested the possibility of hyperviscosity syndrome. The patient received one session of plasma exchange with which her symptoms improved and chest infiltrates resolved (high output pulmonary edema). The case highlights a known but rare manifestation of multiple myeloma, which when diagnosed and treated quickly can have gratifying results.
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A pleural effusion is the abnormal collection of fluid between the parietal and visceral pleura layers of tissue that form the lining of the lungs and chest cavity. It can occur independently or due to surrounding parenchymal diseases, such as infection, malignancy, or inflammatory conditions.
Clinical Manifestations:

