Hyperammonemic encephalopathy in multiple myeloma

✍ Scribed by Keller, Dean R.; Keller, Kathryn

• Publisher: John Wiley and Sons
• Year: 1998
• Tongue: English
• Weight: 278 KB
• Volume: 57
• Category: Article
• ISSN: 0361-8609
• DOI: 10.1002/(sici)1096-8652(199803)57:3<264::aid-ajh23>3.0.co;2-9

✦ Synopsis

lymph node involvement with rt ureter compression that required a stent insertion. Brain CT showed a suprasellar lesion involving the diencephalic and chiasmatic regions (Fig. 1a). The patient was treated with CdA (2 hr-infusion of 0.14 mg/kg die × 7 days) and Dexamethasone (0.3 mg/kg die × 4 days). Therapy was well tolerated without significant hematologic toxicity (WHO G4 leukopenia duration, 3 days; no thrombocytopenia). Partial regression of the liver, kidney, and lymph node involvement and complete regression of the brain lesions (Fig. 1b) were documented 1 month later by CT. The patient was discharged on May 24 with complete regression of the neurological symptoms. On June 13 she died from an acute cerebral vascular accident (CVA) of ischemic origin (brain CT not shown). In this patient, a single cycle of CdA induced complete regression of the brain lesion. CVA as a complication of therapy with CdA has not been reported; a relationship between treatment and the final event is unlikely.