Multiple myeloma-induced hyperammonemic encephalopathy: an entity associated with high in-patient mortality.
Hyperammonemia attributed to multiple myeloma (MM) has been rarely reported. We present 6 patients from our institution and 34 from the literature with MM-induced hyperammonemic encephalopathy. The median age was 67 years with male:female ratio of 1.8:1. The median ammonia level was 114 umol/L. IgG and IgA MM was seen in 40% and 35% of cases, respectively. The in-patient mortality was 48%. The in-patient mortality was 31% in patients who received MM-directed therapy and 100% in those who did not received MM-directed therapy. Hyperammonemic encephalopathy is a rare complication in MM and is associated with high in-patient mortality.
Division of Hematology and Oncology, Mayo Clinic, Rochester, MN, USA.
Anthony
A
Pham
John L
JL
Reagan
Jorge J
JJ
Castillo
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001927:Brain Diseases / Q000209:etiology* / Q000401:mortality*; D005260:Female; D006801:Humans; D022124:Hyperammonemia / Q000150:complications* / Q000209:etiology*; D008297:Male; D008875:Middle Aged; D009101:Multiple Myeloma / Q000150:complications* / Q000188:drug therapy / Q000473:pathology; D009367:Neoplasm Staging; D012189:Retrospective Studies; D055815:Young Adult
Ammonia; Encephalopathy; Myeloma