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Multimodal Bioluminescent and Positronic-emission Tomography/Computational Tomography Imaging of Multiple Myeloma Bone Marrow Xenografts in NOG Mice

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[Hyperammonemic encephalopathy in multiple myeloma].

A Oestmann¹, D Aujesky¹

¹Universitätsklinik für Allgemeine Innere Medizin, Inselspital, Universitätsspital Bern, Schweiz.

Deutsche Medizinische Wochenschrift (1946)

|July 30, 2014

Summary

In patients with multiple myeloma experiencing unexplained dyspnea, consider hyperammonemic encephalopathy. Elevated serum ammonia levels can cause respiratory alkalosis and neurological symptoms, even with normal neurological exams.

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Area of Science:

Hematology
Neurology
Oncology

Background:

Multiple myeloma is a hematologic malignancy.
Refractory multiple myeloma presents treatment challenges.
Dyspnea can be a complex symptom in cancer patients.

Observation:

A patient with advanced, refractory multiple myeloma developed dyspnea.
Initial investigations ruled out cardiopulmonary and neurological causes.
Elevated serum ammonia levels (144 µmol/l) were identified, leading to a diagnosis of hyperammonemic encephalopathy.

Findings:

Hyperammonemic encephalopathy presented as dyspnea and respiratory alkalosis in a multiple myeloma patient.
Standard myeloma treatments were ineffective.
The patient ultimately succumbed to aspiration pneumonia.

Implications:

Respiratory alkalosis in multiple myeloma patients warrants investigation for hyperammonemia.
Hyperammonemia is a potentially treatable cause of neurological and respiratory symptoms in cancer.
Early diagnosis of hyperammonemia may improve patient outcomes.