Patients with both malignant and non-malignant haematological disease may present with dramatic and often life threatening complications of their diseases. This article deals with five of the most common emergencies encountered by haematologists. Although these conditions are not seen commonly in day to day clinical practice, recognition of the underlying pathological processes is important in determining the likely cause of the abnormalities and is helpful in determining the specific treatment needed. Hyperviscosity syndrome This may be caused by several haematological conditions. Blood viscosity is a function of the concentration and composition of its components. A marked increase in plasma proteins (for example, monoclonal immunoglobulin in myeloma) or cellular constituents (for example, white blood cells in acute leukaemia) will raise the overall blood viscosity. This leads to sludging of the microcirculation and a variety of clinical manifestations. Hyperviscosity may present insidiously or acutely with neurological symptoms and signs.
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