Skip to main content
NCBI home page
The Journal of Clinical Investigation logoLink to The Journal of Clinical Investigation
. 1970 Jan;49(1):15–20. doi: 10.1172/JCI106213

The hyperviscosity syndrome

I. In IgG myeloma. The role of protein concentration and molecular shape

Malcolm R MacKenzie 1,2,3, H Hugh Fudenberg 1,2,3, Robert A O'Reilly 1,2,3
PMCID: PMC322439  PMID: 5409803

Abstract

The hyperviscosity syndrome is an uncommon complication in IgG myeloma. Its occurrence has been ascribed to the presence in the serum of high molecular weight polymers of the IgG proteins. Three patients with IgG myeloma and the clinical hyperviscosity syndrome were investigated, none of whom had IgG polymers in the serum by analytical ultracentrifugation. Relative serum viscosity in these patients ranged from 10 to 17.4 (normal 1.4-1.8). The total serum proteins ranged from 14 to 19 g/100 ml of which 10 to 17 g/100 ml was IgG globulin. Physicochemical studies of two of the isolated myeloma proteins indicated that they were of normal molecular weight (near 158,000 and 162,000). Protein Ca had a normal molecular radius (52.2 A) and configuration, (intrinsic viscosity of 5.5 cc/g, frictional ratio 1.48), but was present in very high concentration in the serum. Protein Pur had an increased molecular radius (58.2 A) and was asymmetrical (intrinsic viscosity 10.2 cc/g, frictional ratio 1.63). These results indicate that the concentration and molecular configuration of the myeloma protein are important determinants of the presence or absence of the hyperviscosity syndrome.

Full text

PDF
15

Images in this article

17Image
on p.17

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. ACKERS G. K. MOLECULAR EXCLUSION AND RESTRICTED DIFFUSION PROCESSES IN MOLECULAR-SIEVE CHROMATOGRAPHY. Biochemistry. 1964 May;3:723–730. doi: 10.1021/bi00893a021. [DOI] [PubMed] [Google Scholar]
  2. Bjorneboe M., Jensen K. B. A case of myelomatosis with normal colloid osmotic pressure in spite of extremely high serum protein concentration. (Hyperviscosity syndrome due to aggregation of myeloma globulin molecules?). Acta Med Scand Suppl. 1966;445:212–215. doi: 10.1111/j.0954-6820.1966.tb02363.x. [DOI] [PubMed] [Google Scholar]
  3. FAHEY J. L., BARTH W. F., SOLOMON A. SERUM HYPERVISCOSITY SYNDROME. JAMA. 1965 May 10;192:464–467. doi: 10.1001/jama.1965.03080190030008. [DOI] [PubMed] [Google Scholar]
  4. Kekwick R. A. The serum proteins in multiple myelomatosis. Biochem J. 1940 Sep;34(8-9):1248–1257. doi: 10.1042/bj0341248. [DOI] [PMC free article] [PubMed] [Google Scholar]
  5. Kochwa S., Smith E., Brownell M., Wasserman L. R. Aggregation of IgG globulin in vivo. II. Physicochemical properties of the isolated protein. Biochemistry. 1966 Jan;5(1):277–285. doi: 10.1021/bi00865a036. [DOI] [PubMed] [Google Scholar]
  6. Kopp W. L., Beirne G. J., Burns R. O. Hyperviscosity syndrome in multiple myeloma. Am J Med. 1967 Jul;43(1):141–146. doi: 10.1016/0002-9343(67)90156-8. [DOI] [PubMed] [Google Scholar]
  7. LEVY H. B., SOBER H. A. A simple chromatographic method for preparation of gamma globulin. Proc Soc Exp Biol Med. 1960 Jan;103:250–252. doi: 10.3181/00379727-103-25476. [DOI] [PubMed] [Google Scholar]
  8. LOWRY O. H., ROSEBROUGH N. J., FARR A. L., RANDALL R. J. Protein measurement with the Folin phenol reagent. J Biol Chem. 1951 Nov;193(1):265–275. [PubMed] [Google Scholar]
  9. MILLER F., METZGER H. CHARACTERIZATION OF A HUMAN MACROGLOBULIN. I. THE MOLECULAR WEIGHT OF ITS SUBUNIT. J Biol Chem. 1965 Aug;240:3325–3333. [PubMed] [Google Scholar]
  10. NOELKEN M. E., NELSON C. A., BUCKLEY C. E., 3rd, TANFORD C. GROSS CONFORMATION OF RABBIT 7 S GAMMA-IMMUNOGLOBULIN AND ITS PAPAIN-CLEAVED FRAGMENTS. J Biol Chem. 1965 Jan;240:218–224. [PubMed] [Google Scholar]
  11. ROSEVEAR J. W., SMITH E. L. Glycopeptides. I. Isolation and properties of glycopeptides from a fraction of human gamma-globulin. J Biol Chem. 1961 Feb;236:425–435. [PubMed] [Google Scholar]
  12. SCHEIDEGGER J. J. Une micro-méthode de l'immuno-electrophorèse. Int Arch Allergy Appl Immunol. 1955;7(2):103–110. [PubMed] [Google Scholar]
  13. SMITH E., KOCHWA S., WASSERMAN L. R. AGGREGATION OF IGG GLOBULIN IN VIVO. I. THE HYPERVISCOSITY SYNDROME IN MULTIPLE MYELOMA. Am J Med. 1965 Jul;39:35–48. doi: 10.1016/0002-9343(65)90243-3. [DOI] [PubMed] [Google Scholar]
  14. Sarkar P. K., Doty P. The optical rotatory properties of the beta-configuration in polypeptides and proteins. Proc Natl Acad Sci U S A. 1966 Apr;55(4):981–989. doi: 10.1073/pnas.55.4.981. [DOI] [PMC free article] [PubMed] [Google Scholar]
  15. Somer T. The viscosity of blood, plasma and serum in dys- and paraproteinemias. Acta Med Scand Suppl. 1966;456:1–97. [PubMed] [Google Scholar]
  16. YPHANTIS D. A. EQUILIBRIUM ULTRACENTRIFUGATION OF DILUTE SOLUTIONS. Biochemistry. 1964 Mar;3:297–317. doi: 10.1021/bi00891a003. [DOI] [PubMed] [Google Scholar]

Articles from Journal of Clinical Investigation are provided here courtesy of American Society for Clinical Investigation

RESOURCES