Evaluate hyperviscosity syndrome associated with monoclonal gammopathy states (myeloma, macroglobulinemia of Waldenstrom, and other dysproteinemias), including occasional cases of rheumatoid arthritis, SLE, systemic lupus erythematosus, hyperfibrinogenemia.

Gold serum separator (SST) tube

Immediately following collection, thoroughly mix sample by gently inverting 5 times

1. Allow sample to clot for a minimum of 30 minutes
2. Spin within two (2) hours of sample collection

Gold serum separator (SST) tube

Red serum vial/tube - 5 mL

1. Allow sample to clot
2. Spin within two (2) hours of sample collection
3. Transfer serum to a Transfer vial/tube with cap - 12mL (LabCorp), labelled as serum

Transfer vial/tube with cap - 12mL (LabCorp)

Refrigerated (preferred)  - 14 days

Ambient - 14 days

Frozen - 14 days

Freeze/thaw cycles: stable x3

• Hemolysis
• Fibrin clots
• Quantity not sufficient for analysis

Viscometry

0 - 5 years:   not established

6 - 50 years: 1.4 - 2.0 relative to saline

>50 years:    1.4 - 2.1 relative to saline

Values >2.7 may indicate paraproteinemia is present.

Hyperviscosity most frequent (33% of cases) with IgM monoclonal gammopathy (Waldenstrom macroglobulinemia); next with IgA myeloma. When IgG myeloma leads to hyperviscosity, IgG levels are usually very significantly elevated. A relative viscosity of 6-7 usually results in symptoms of the hyperviscosity syndrome, they have however been described with lower levels of relative viscosity (ie, 4).] Neonatal hyperviscosity, usually but not always associated with polycythemia, may be accompanied by a fairly typical clinical picture. Plethora, hypoglycemia, lethargy, and jitteriness/seizures (CNS symptoms) occur. There may be symptoms and findings suggesting congenital heart disease (CHD) (ie, respiratory distress, cardiacenlargement, and cyanosis). False diagnoses of CHD have been made in such cases. About 50% of such infants have modest hyperbilirubinemia (bilirubin >12 mg/dL).