Hyperviscosity syndrome secondary to a myeloma-associated IgG(1)kappa paraprotein strongly reactive against the HIV-1 p24 gag antigen

Hyperviscosity syndrome secondary to hypergammaglobulinemia is a rare and p otentially fatal complication in patients with human immunodeficiency virus type-1 (HIV-1) infection. We studied an HIV-1-positive patient with sympto matic hyperviscosity attributable to IgG(1)kappa multiple myeloma, The pati ent initially responded to plasmapheresis and was subsequently treated with cytotoxic immunosuppressive chemotherapy, The patient remained asymptomati c during a 3-year follow-up period. The monoclonal IgG(1)kappa gammopathy e volved to a biclonal variant of the same subtype with an expansion of marro w plasma cell population. Western blot analysis demonstrated that this myel oma-associated paraprotein was strongly reactive against the HIV-1 p24 gag antigen. (C) 2000 Wiley-Liss. Inc.