Which therapy is used to reduce circulating proteins in hyperviscosity syndrome?

Which therapy is used to reduce circulating proteins in hyperviscosity syndrome?

• A. IV resuscitation
• B. Antibiotic therapy
• C. Dialysis
• D. Plasmapheresis

Answer: (D)

Hyperviscosity occurs when high levels of large circulating proteins thicken the blood, slowing flow especially to the eyes and brain. The fastest way to lower those circulating proteins and reduce viscosity is plasmapheresis, a therapeutic plasma exchange. In this procedure, plasma containing the excess proteins is removed and replaced with albumin or donor plasma, quickly decreasing viscosity and improving microcirculation. This approach is crucial in conditions like Waldenström macroglobulinemia or cryoglobulinemia where the viscous plasma drives symptoms such as visual changes, headaches, dizziness, and neurologic deficits. Other options don’t achieve this rapid removal of large proteins: intravenous fluids help with volume status but don’t reduce protein concentration; antibiotics target infection rather than viscosity; dialysis mainly clears small solutes and is not effective at swiftly removing high-molecular-weight immunoglobulins like IgM, so it doesn’t correct the viscosity in the acute setting.

Hyperviscosity occurs when high levels of large circulating proteins thicken the blood, slowing flow especially to the eyes and brain. The fastest way to lower those circulating proteins and reduce viscosity is plasmapheresis, a therapeutic plasma exchange. In this procedure, plasma containing the excess proteins is removed and replaced with albumin or donor plasma, quickly decreasing viscosity and improving microcirculation. This approach is crucial in conditions like Waldenström macroglobulinemia or cryoglobulinemia where the viscous plasma drives symptoms such as visual changes, headaches, dizziness, and neurologic deficits.

Other options don’t achieve this rapid removal of large proteins: intravenous fluids help with volume status but don’t reduce protein concentration; antibiotics target infection rather than viscosity; dialysis mainly clears small solutes and is not effective at swiftly removing high-molecular-weight immunoglobulins like IgM, so it doesn’t correct the viscosity in the acute setting.