title: [Primary plasma cell leukemia complicated with high-output cardiac failure and hyperammonemia].
abstract: A 23-year-old male patient with plasma cell leukemia showed characteristic clinical features: accelerating heart failure and consciousness disturbance accompanied with an increase of plasma cells in peripheral blood. Evaluation of cardiac function revealed a hyperdynamic cardiac state with low somatic vascular resistance, indicating high-output cardiac failure. However no disorders causing high-output cardiac failure were found. Consciousness disturbance and hyperammonemia with serum amino acid abnormality of unknown origin were also demonstrated. After intensive combined chemotherapy (MVD + VAD), high-output cardiac failure and hyperammonemia improved with disappearance of plasma cells, suggesting that these symptoms were closely related with progression of plasma cell leukemia.
authors.affiliation: Second Department of Internal Medicine, Kumamoto University School of Medicine.
authors.forename: E
authors.initials: E
authors.lastname: Nakahashi
authors.forename: N
authors.initials: N
authors.lastname: Kuribayashi
authors.forename: N
authors.initials: N
authors.lastname: Tsuji
authors.forename: T
authors.initials: T
authors.lastname: Kawaguchi
authors.forename: H
authors.initials: H
authors.lastname: Hata
authors.forename: H
authors.initials: H
authors.lastname: Matsuzaki
authors.forename: K
authors.initials: K
authors.lastname: Shimizu
authors.forename: K
authors.initials: K
authors.lastname: Takatsuki
mesh_terms: D000328:Adult; D000641:Ammonia / Q000097:blood*; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D002302:Cardiac Output; D003907:Dexamethasone; D004317:Doxorubicin / Q000008:administration & dosage; D006333:Heart Failure / Q000209:etiology* / Q000503:physiopathology; D006801:Humans; D007952:Leukemia, Plasma Cell / Q000150:complications* / Q000188:drug therapy; D008297:Male; D016685:Mitomycin / Q000008:administration & dosage; D011374:Progesterone / Q000008:administration & dosage; D014747:Vinblastine / Q000008:administration & dosage; D014750:Vincristine / Q000008:administration & dosage
chemical_list: D011374:Progesterone; D016685:Mitomycin; D014750:Vincristine; D014747:Vinblastine; D000641:Ammonia; D003907:Dexamethasone; D004317:Doxorubicin