Hyperviscosity caused by hyaluronic acid in serum in a case of Wilms' tumor

We describe the case of a three-year-old girl with Wilms' tumor, whose serum showed at least a fivefold increase in relative viscosity although concentrations of albumin and immunoglobulins were normal. An unusual electrophoretogram of serum protein prompted further investigation. The increased viscosity was caused by the presence of high concentrations of hyaluronic acid, a glycosaminoglycan normally not detectable in serum.