Hyperviscosity Syndrome

Hyperviscosity syndrome (HVS) occurs when certain medical conditions cause your blood to become too thick to flow through your blood vessels. This condition is a medical emergency. Without treatment, thick blood can block your arteries and lead to organ failure.

Certain blood disorders and autoimmune diseases can cause HVS. These underlying conditions may cause abnormal red blood cells that can’t move through your blood vessels. In some cases, the conditions mean you have too many red blood cells, white blood cells or platelets. Unusually large numbers of blood cells can thicken blood.

Symptoms of hyperviscosity syndrome

This condition causes what healthcare providers call the "triad of hyperviscosity." This term refers to three sets of symptoms:

• Chronic nosebleeds and bleeding gums
• Blurred vision or other vision issues
• Headache, dizziness, vertigo and seizure symptoms, like uncontrollable movements or staring

HVS may cause other symptoms, including:

• Skin discoloration, where your skin looks reddish or darker than usual
• Chest pain
• Difficulty walking
• Hearing issues
• Shortness of breath

Hyperviscosity syndrome causes

Waldenström macroglobulinemia, a type of blood cancer, is the most common cause. But many different issues may cause HVS, including:

• Autoimmune diseases, like lupus, rheumatoid arthritis and Sjögren’s syndrome
• Blood cancers, like acute myeloid leukemia, multiple myeloma and myelodysplastic syndrome
• Blood disorders, including essential thrombocytosis, leukemia and polycythemia

Other conditions that may cause it include:

• Chronic hypoxia: This is a lack of oxygen to your tissues.
• Cryoglobulinemia: This happens when abnormal proteins clump together in your blood.
• Paraneoplastic syndromes: This cancer complication happens when your immune system’s reaction to cancer damages healthy cells.

How doctors diagnose HVS

Healthcare providers will ask about your health history and your symptoms. Specifically, they’ll ask about issues like unusual bleeding, vision issues, and dizziness or vertigo. They may do the following blood tests:

• Arterial blood gas: This test measures oxygen and carbon dioxide levels in your blood.
• Bilirubin test: This checks bilirubin, the yellowish substance that your body makes when your red blood cells break down.
• CBC test: This test measures blood cell and plasma levels.
• Creatinine test: Providers do this test to check your kidney function.
• Liver function test: Your liver is another organ that’s affected when you have thick blood.
• Serum viscosity: This test measures your blood serum thickness and how fast the serum flows. Blood serum is a liquid that’s left behind after your blood clots.

How is hyperviscosity syndrome treated?

Your treatment will depend on the condition that causes thick blood. In severe cases, your healthcare provider may do a partial plasma exchange.

Recovery time

People who have plasma exchange treatment typically recover within a few hours.

When should I seek care?

You can develop HVS if you have certain autoimmune diseases, blood cancers or blood disorders. If you have one of these conditions, talk to your healthcare provider if you have symptoms like chronic nosebleeds, blurred vision, headaches or vertigo.

What can I expect if I have this condition?

Prompt treatment typically controls HVS. But you’ll need ongoing treatment for the underlying condition that caused thickened blood. Otherwise, hyperviscosity syndrome can come back.