Neuro-Ophthalmic Presentation of Hyperviscosity Syndrome Uncovering Multiple Myeloma Diagnosis
DOI:
https://doi.org/10.60591/crspmi.473Keywords:
Blood Viscosity, Eye Diseases, Multiple Myeloma, Retinal HemorrhageAbstract
Multiple myeloma, characterized by uncontrolled plasma cell proliferation in the bone marrow and excessive immunoglobulin production, can lead to hyperviscosity syndrome, posing an oncologic emergency.
We present the case of an elderly woman exhibiting neuro-ophthalmological symptoms such as confusion, frontal syndrome, ataxia and deteriorating vision, alongside retinal hemorrhages. Diagnosis revealed IgG/Kappa multiple myeloma with bone marrow involvement, confirmed through further investigations. The patient was also found to have high blood viscosity. Lumbar puncture and cerebral magnetic resonance imaging (MRI) supported the diagnosis, indicating elevated protein levels and ischemic lesions. Prompt treatment, including dexamethasone pulses, therapeutic plasma exchange and chemotherapy, led to marked improvement.
This case underscores the importance of thorough ophthalmic and systemic evaluations in patients with suspected hyperviscosity, as neuro-ophthalmological symptoms may signal a life-threatening hematologic condition.
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Copyright (c) 2026 Rita Noversa de Sousa, Ângelo Fonseca, Paula Salgado, André Azevedo, Ana P. Ferro
This work is licensed under a Creative Commons Attribution 4.0 International License.
