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[Reversible posterior leucoencephalopathy due to hypercalcaemia]
C M C Klomp1, M W C van den Broek, J Buijs
1Atrium Medisch Centrum, Postbus 4446, 6401 CX Heerlen. carolijnklomp@hotmail.com
Nederlands Tijdschrift Voor Geneeskunde
|March 24, 2006
Summary
A rare case of reversible posterior leucoencephalopathy syndrome caused by multiple myeloma-induced hypercalcaemia was successfully treated. Prompt treatment normalized calcium levels, reversing neurological and radiological abnormalities.
Area of Science:
- Neurology
- Oncology
- Nephrology
Background:
- Hypercalcaemia, often associated with malignancies like multiple myeloma, can manifest with diverse neurological symptoms.
- Posterior reversible encephalopathy syndrome (PRES) is a clinicoradiological entity characterized by neurological deficits and characteristic brain imaging findings.
- Multiple myeloma, particularly IgD type, is a rare but significant cause of pathological hypercalcaemia.
Observation:
- A 60-year-old woman presented with behavioral changes, cognitive decline, cortical blindness, and headache.
- These symptoms were attributed to reversible posterior leukoencephalopathy syndrome (RPLS).
Findings:
- The patient's RPLS was caused by severe hypercalcemia secondary to IgD multiple myeloma.
- Treatment with isotonic saline and pamidronate normalized serum calcium levels.
- Radiological brain abnormalities and neurological deficits resolved completely following treatment.
Implications:
- This case highlights a rare but treatable cause of RPLS.
- Prompt management of hypercalcemia is crucial for reversing neurological deficits.
- Understanding the neurotoxic effects of hypercalcemia is important for clinical practice.