GuidelinesEML (Adult Hospital STG)

Haematologic Emergencies

Standard Treatment Guidelines and Essential Medicines List for South Africa, Hospital Level, Adults 2019 Edition

Febrile Neutropenia

Hyperviscosity and Leucostatic Syndromes

FEBRILE NEUTROPENIA

See Febrile neutropenia.

HYPERVISCOSITY AND LEUCOSTATIC SYNDROMES

ICD-10 Code: D78.9

DESCRIPTION

Hyperviscosity is seen in patients with Waldenström’s macroglobuliemia and multiple myeloma, while leucostasis may be seen in patients with acute leukaemias and chronic myeloid leukaemia with high white cell counts.
Sludging and decreased perfusion of the microvasculature and vascular stasis occur due to increased paraproteins or leucostasis.
Patients present with spontaneous bleeding, visual signs and symptoms and neurologic defects.

GENERAL MEASURES

Perform investigations: FBC, peripheral blood smear, serum protein electrophoresis (SPEP) and erythrocyte sedimentation rate (ESR).
Monitor urine, electrolytes and creatinine.

REFERRAL

Ensure adequate hydration and refer.

Standard Treatment Guidelines and Essential Medicines List for South Africa, Hospital Level, Adults 2024 Edition