Paraprotein-induced hyperviscosity. A reversible cause of stroke

Area of Science:

• Hematology
• Neurology
• Oncology

Background:

• IgG plasma cell leukemia is a rare plasma cell dyscrasia.
• Hyperviscosity syndrome (HVS) is an uncommon complication of plasma cell neoplasms.
• Neurologic deficits can be the presenting symptom of HVS.

Observation:

• This case highlights an unusual presentation of HVS in IgG plasma cell leukemia.
• Patients with focal neurologic deficits require evaluation for HVS, especially with known paraproteinemia.
• Elevated serum viscosity is the hallmark of HVS.

Findings:

• The study identifies a potential link between IgG plasma cell leukemia and HVS.
• Prompt recognition and management of HVS are crucial for patient outcomes.
• Emergent plasmapheresis is an effective treatment for HVS-induced neurologic deficits.

Implications:

• Clinicians should consider HVS in the differential diagnosis of neurologic deficits in patients with IgG plasma cell leukemia.
• Early detection of elevated serum viscosity can guide timely therapeutic interventions.
• Plasmapheresis offers a potentially reversible treatment option for acute neurologic impairment in this setting.