Abstract
A patient with multiple myeloma had severe epistaxis and retinal hemorrhages. The relative serum viscosity and concentration of serum proteins were markedly increased. Immunologic studies and ultracentrifugal analysis revealed 7S IgG myeloma protein without aggregates. Plasmapheresis was the effective immediate treatment of the hyperviscosity syndrome. Treatment with cyclophosphamide further lowered the concentration of myeloma protein and the relative serum viscosity and then maintained them at asymptomatic levels. Concomitantly, sludging of red blood cells in conjunctival vessels decreased and retinal hemorrhages cleared. Treatment also markedly improved the concentrating and diluting abilities of the kidney.
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