Detection of increased viscosity
Monitoring patients with hyperviscosity syndrome
This test is not useful for patients with small concentrations of monoclonal proteins.
Capillary Measurement
Serum Red
Collection Container/Tube: Red top (serum gel/SST are not acceptable)
Submission Container/Tube: Plastic vial
Specimen Volume: 3 mL
Collection Instructions:
1. Keep specimen at 37 degrees C (eg, 37 degrees C Thermopak, heat block) until after centrifugation.
2. Centrifuge and aliquot serum into plastic vial.
If not ordering electronically, complete, print, and send 1 of the following forms with the specimen:
0.75 mL
Gross hemolysis | OK |
Gross lipemia | OK |
Gross icterus | OK |
Specimen Type | Temperature | Time | Special Container |
---|---|---|---|
Serum Red | Refrigerated (preferred) | 28 days | |
Frozen | 28 days | ||
Ambient | 14 days |
Detection of increased viscosity
Monitoring patients with hyperviscosity syndrome
This test is not useful for patients with small concentrations of monoclonal proteins.
Viscosity is the property of fluids to resist flow. Hyperviscosity may be manifested by nasal bleeding, blurred vision, headaches, dizziness, nystagmus, deafness, diplopia, ataxia, paresthesias, or congestive heart failure. Funduscopic examination reveals dilation of retinal veins and flame shaped retinal hemorrhages.
The most common cause of serum hyperviscosity is the presence of large concentrations of IgM monoclonal proteins, and Waldenstrom macroglobulinemia accounts for 80% to 90% of hyperviscosity cases. Hyperviscosity syndrome can also occur in multiple myeloma patients.
Because the ability of a monoclonal protein to cause hyperviscosity is affected by its concentration, molecular weight, and aggregation, sera with concentrations of monoclonal IgM greater than 4 g/dL, IgA greater than 5 g/dL, or IgG greater than 6 g/dL should be tested for hyperviscosity.
Serum viscosity and electrophoresis are recommended before and after plasmapheresis in order to correlate viscosity and M-spike with patient symptoms. This correlation may be useful for anticipating the need for repeat plasmapheresis.
< or =1.5 centipoises
Although viscosities greater than 1.5 centipoises (cP) are abnormal, hyperviscosity is rarely present unless the viscosity is greater than 3 cP.
Failure to follow specimen handling instructions may cause false-low results.
Hyperviscosity syndrome may not be present even if the viscosity is greater than 3 centipoises.
1. Gertz MA, Kyle RA: Hyperviscosity syndrome. J Intensive Care Med. 1995;10:128-141
2. Gertz MA: Acute hyperviscosity: syndromes and management. Blood. 2018;132(13):1379-1385
3. Kesmarky G, Kenyeres P, Rabai M, Toth K: Plasma viscosity: a forgotten variable. Clin Hemorheol Microcirc. 2008;39(1-4):243-246
4. Wood AW: Rheology of blood. In: Physiology, Biophysics, and Biomedical Engineering. CRC Press; 2012:217-233
The Benson BV200 automated viscometer employs vacuum pressure through a capillary to measure the dynamic viscosity of serum samples. Samples at ambient temperature are aspirated by the sample probe, which is heated to 37 degrees C. Viscosity results are calculated by the instrument at both 25 degrees C and 37 degrees C temperature points. Viscosity units on board the instrument are mPa.s (milli-pascal seconds), which is the International Standard (SI) unit for viscosity. Centipoise (cP) units are named after French physicist Jean Leonard Marie Poiseuille and are used in the centimeter-gram-second (CGS) system of units. 1 mPa.s is equal to 1 cP.(Instruction manual: BV200 Automated Clinical Viscometer User Manual. Benson Viscometers; Ver. 1.5, 02/2020)
Monday through Friday
This test has been modified from the manufacturer's instructions. Its performance characteristics were determined by Mayo Clinic in a manner consistent with CLIA requirements. This test has not been cleared or approved by the US Food and Drug Administration.
85810
Test Id | Test Order Name | Order LOINC Value |
---|---|---|
SVISC | Viscosity, S | 3128-6 |
Result Id | Test Result Name |
Result LOINC Value
Applies only to results expressed in units of measure originally reported by the performing laboratory. These values do not apply to results that are converted to other units of measure.
|
---|---|---|
SVISC | Viscosity, S | 3128-6 |