Hyperviscosity syndrome secondary to a myeloma‐associated IgG ₁ κ paraprotein strongly reactive against the HIV‐1 p24 <i>gag</i> antigen

Abstract

Hyperviscosity syndrome secondary to hypergammaglobulinemia is a rare and potentially fatal complication in patients with human immunodeficiency virus type-1 (HIV-1) infection. We studied an HIV-1-positive patient with symptomatic hyperviscosity attributable to IgG1κ multiple myeloma. The patient initially responded to plasmapheresis and was subsequently treated with cytotoxic immunosuppressive chemotherapy. The patient remained asymptomatic during a 3-year follow-up period. The monoclonal IgG1κ gammopathy evolved to a biclonal variant of the same subtype with an expansion of marrow plasma cell population. Western blot analysis demonstrated that this myeloma-associated paraprotein was strongly reactive against the HIV-1 p24 gag antigen. Am. J. Hematol. 64:210–213, 2000. © 2000 Wiley-Liss, Inc.