{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,21]],"date-time":"2026-08-21T12:41:20Z","timestamp":1787316080701,"version":"build-2736575974"},"reference-count":17,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2026,2,18]],"date-time":"2026-02-18T00:00:00Z","timestamp":1771372800000},"content-version":"vor","delay-in-days":17,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,2,1]],"date-time":"2026-02-01T00:00:00Z","timestamp":1769904000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J of Clinical Apheresis"],"published-print":{"date-parts":[[2026,2]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:p>Severe hypertriglyceridemia can increase the risk of acute pancreatitis, but also clinically significant hyperviscosity syndrome characterized by the typical signs of neurologic and visual manifestations. Hyperviscosity syndrome is a well\u2010established medical emergency. However, hyperviscosity syndrome induced by hypertriglyceridemia may be under\u2010recognized, particularly when pancreatitis and other classical signs of hyperviscosity syndrome are absent. We describe an index case of extreme hypertriglyceridemia presenting with cardiorespiratory symptoms (chest pain and dyspnea) due to suspected hyperviscosity, but without clinical or radiographic evidence of pancreatitis, successfully treated with therapeutic plasma exchange (TPE). We then review the limited, but growing body of published case reports describing TPE for hypertriglyceridemic hyperviscosity without acute pancreatitis. Across cases, TPE reliably achieved rapid triglyceride reduction and resolution of hyperviscosity symptoms. This review highlights diagnostic challenges, therapeutic indications, and the rationale for early TPE in symptomatic hyperviscosity even when pancreatitis is not present.<\/jats:p>","DOI":"10.1002\/jca.70095","type":"journal-article","created":{"date-parts":[[2026,2,19]],"date-time":"2026-02-19T05:42:41Z","timestamp":1771479761000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Milky Plasma, Murky Diagnosis: Urgent Plasma Exchange for Severe Hypertriglyceridemia\u2010Induced Hyperviscosity Without Pancreatitis, but With Myocardial Infarction"],"prefix":"10.1002","volume":"41","author":[{"given":"Catherine","family":"Bodnar","sequence":"first","affiliation":[{"name":"Department of Pathology and Laboratory Medicine University of Wisconsin\u2010Madison  Madison Wisconsin USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christina","family":"Hughey","sequence":"additional","affiliation":[{"name":"Department of Medicine University of Wisconsin\u2010Madison  Madison Wisconsin USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ariel","family":"Bodker","sequence":"additional","affiliation":[{"name":"Department of Medicine University of Wisconsin\u2010Madison  Madison Wisconsin USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9906-9694","authenticated-orcid":false,"given":"Chinelo P.","family":"Onyenekwu","sequence":"additional","affiliation":[{"name":"Department of Pathology and Laboratory Medicine University of Wisconsin\u2010Madison  Madison Wisconsin USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,2,18]]},"reference":[{"key":"e_1_2_10_2_1","doi-asserted-by":"publisher","DOI":"10.3390\/genes15020190"},{"key":"e_1_2_10_3_1","doi-asserted-by":"publisher","DOI":"10.1177\/2050640618755002"},{"key":"e_1_2_10_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejim.2014.08.008"},{"key":"e_1_2_10_5_1","doi-asserted-by":"publisher","DOI":"10.1182\/blood-2018-06-846816"},{"key":"e_1_2_10_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0021-9150(01)00656-6"},{"key":"e_1_2_10_7_1","doi-asserted-by":"publisher","DOI":"10.1002\/jca.22043"},{"key":"e_1_2_10_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.emc.2025.03.001"},{"key":"e_1_2_10_9_1","doi-asserted-by":"publisher","DOI":"10.1111\/1744-9987.14094"},{"key":"e_1_2_10_10_1","doi-asserted-by":"publisher","DOI":"10.1111\/sdi.13135"},{"key":"e_1_2_10_11_1","doi-asserted-by":"publisher","DOI":"10.3389\/fonc.2020.00815"},{"key":"e_1_2_10_12_1","doi-asserted-by":"publisher","DOI":"10.1002\/jca.70025"},{"key":"e_1_2_10_13_1","doi-asserted-by":"publisher","DOI":"10.1210\/jcemcr\/luae087"},{"key":"e_1_2_10_14_1","article-title":"Sirolimus\u2010Induced Severe Hypertriglyceridemia Presenting With Signs of Hyperviscosity Syndrome and as Pink Colored Blood: A Case Report","volume":"7","author":"Bender S. T.","year":"2022","journal-title":"Annals of Case Reports"},{"key":"e_1_2_10_15_1","doi-asserted-by":"publisher","DOI":"10.3389\/fmed.2022.870067"},{"key":"e_1_2_10_16_1","first-page":"175","article-title":"Exertional Chest Pain and Dyspnea From Hyperviscosity Syndrome Related to Marginal Zone Lymphoma","volume":"5","author":"Dhakal P.","year":"2014","journal-title":"World Journal of Oncology"},{"key":"e_1_2_10_17_1","doi-asserted-by":"publisher","DOI":"10.12890\/2024_005043"},{"key":"e_1_2_10_18_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0002-9343(01)00643-X"}],"container-title":["Journal of Clinical Apheresis"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/jca.70095","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1002\/jca.70095","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/jca.70095","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,4,28]],"date-time":"2026-04-28T20:01:02Z","timestamp":1777406462000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/jca.70095"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,2]]},"references-count":17,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2026,2]]}},"alternative-id":["10.1002\/jca.70095"],"URL":"https:\/\/doi.org\/10.1002\/jca.70095","archive":["Portico"],"relation":{},"ISSN":["0733-2459","1098-1101"],"issn-type":[{"value":"0733-2459","type":"print"},{"value":"1098-1101","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,2]]},"assertion":[{"value":"2025-12-26","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-02-06","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-02-18","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e70095"}}