title: Hyperviscosity syndrome secondary to a myeloma-associated IgG(1)kappa paraprotein strongly reactive against the HIV-1 p24 gag 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 IgG(1)kappa 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 IgG(1)kappa 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.
authors.affiliation: Department of Medicine, Division of Hematology/Oncology, State University of New York Health Science Center at Brooklyn, 11203, USA.
authors.forename: D K
authors.initials: DK
authors.lastname: Jin
authors.forename: M
authors.initials: M
authors.lastname: Nowakowski
authors.forename: M
authors.initials: M
authors.lastname: Kramer
authors.forename: D W
authors.initials: DW
authors.lastname: Essex
mesh_terms: D000328:Adult; D000937:Antigen-Antibody Reactions; D005260:Female; D016655:HIV Core Protein p24; D006801:Humans; D007074:Immunoglobulin G / Q000276:immunology; D007145:Immunoglobulin kappa-Chains / Q000276:immunology; D009194:Myeloma Proteins / Q000276:immunology*; D010266:Paraproteins / Q000276:immunology*; D008258:Waldenstrom Macroglobulinemia / Q000276:immunology*
chemical_list: D016655:HIV Core Protein p24; D007074:Immunoglobulin G; D007145:Immunoglobulin kappa-Chains; D009194:Myeloma Proteins; D010266:Paraproteins