emDocs - December 05, 2020 - By Brian Sumner and Elizabeth Brem
Reviewed by: Alex Koyfman and Brit Long
"ED Emergency – Hyperviscosity syndrome
In the most severe cases of polycythemia, patients can present with hyperviscosity syndrome. Patients may present with the triad of visual disturbances, focal neurologic deficits and bleeding,as well as shortness of breath and chest pain. In the setting where your patient has signs and symptoms concerning for hyperviscosity syndrome, emergency treatment is prudent. The slowed flow and impaired oxygenation of tissues secondary to the increased viscosity can result in neurologic and cardiovascular compromise. Aggressively hydrate with intravenous fluids and consult hematology.
Take Home Points
- Consider relative vs absolute polycythemia.
- Consider hyperviscosity syndrome.
- Get hematology on board early for severe cases.
- Hydration and plasmapheresis are prudent in hyperviscosity syndrome."