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The utility of therapeutic plasma exchange in Hyperviscosity syndrome associated with juvenile rheumatoid arthritis: A case report
Author(s) -
Green Allen P.,
Gonzalez Adam C.,
Alperin Jack B.,
Burner James D.,
Yates Sean G.
Publication year - 2021
Publication title -
journal of clinical apheresis
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.697
H-Index - 46
eISSN - 1098-1101
pISSN - 0733-2459
DOI - 10.1002/jca.21903
Subject(s) - medicine , hyperviscosity syndrome , hyperviscosity , juvenile rheumatoid arthritis , rheumatoid arthritis , apheresis , macroglobulinemia , waldenstrom macroglobulinemia , bleeding diathesis , plasmapheresis , rheumatoid factor , blood viscosity , dermatology , immunology , arthritis , multiple myeloma , platelet , antibody , lymphoma
Hyperviscosity syndrome (HVS) is a life‐threatening syndrome caused by high concentrations of large plasma proteins like IgM, rheumatoid factor, and other immune complexes, leading to increased blood viscosity and symptoms such as visual abnormalities, neurological impairment, bleeding diathesis, and thrombosis. While Waldenström's macroglobulinemia accounts for 80% to 90% of cases, HVS may develop in other clinical settings characterized by elevations in plasma proteins. Limited evidence currently exists describing the safety and efficacy of therapeutic plasma exchange (TPE) for the management of HVS secondary to non‐neoplastic conditions. We report a case of recurrent HVS associated with juvenile rheumatoid arthritis and Felty syndrome that demonstrated improvement in clinical symptoms following initiation of TPE. These findings suggest that TPE may be utilized as an adjunct treatment option in patients with HVS secondary to autoimmune disorders.