[A case of hyperammonemia presented in a patient with multiple myeloma]

Area of Science:

• Neurology
• Oncology
• Nephrology

Background:

• Multiple myeloma is a plasma cell malignancy.
• Hyperammonemia-induced encephalopathy is a rare neurological complication.
• This condition can occur in the absence of liver failure.

Observation:

• A 78-year-old woman with multiple myeloma presented with acute delirium.
• Elevated serum ammonia levels were detected.
• Hepatic function tests were normal.

Findings:

• The patient's delirium was attributed to hyperammonemia.
• This suggests a link between multiple myeloma and elevated ammonia levels.
• Neurological symptoms can manifest without typical signs of liver dysfunction.

Implications:

• Clinicians should consider hyperammonemia-induced encephalopathy in multiple myeloma patients with unexplained delirium.
• Effective management requires addressing the underlying multiple myeloma.
• Early recognition and treatment can improve patient outcomes.