A Case of Hyperviscosity Syndrome in Rheumatoid Arthritis

Hyperviscosity syndrome (HVS) is a rare complication of bothmonoclonal and polyclonal disorders associated with elevation of immunoglobulins. Here, we describe a female patient who presented with shortness of breath and a history of seropositive rheumatoid arthritis with deformities, significant barriers to care, and poor therapeutic adherence. Her rheumatoid factor titer was greater than 1000 kIU/L, and she had an elevated serum viscosity level with her presentation consistent with HVS which improved significantly after therapeutic plasmapheresis. Our case highlights the presentation of rare but potentially life-threatening HVS that can occur in patients with systemic autoimmune rheumatic disorder.