Korean J Hematol 2002; 37(1):
Published online March 31, 2002
© The Korean Society of Hematology
의식장애를 동반한 고암모니아혈증과 혈청 아미노산 이상을 보인 다발성골수종 1례
이재훈, 고윤웅, 맹호영, 정준원, 김진석, 장준호, 김윤재, 최성우, 이승태, 민유홍, 한지숙
연세대학교 의과대학 내과학교실
A Case of Serum Amino Acid Disturbance with Hyperammonemia in a Patient with Multiple Myeloma
Hyperviscosity and hypercalcemia are the common causes of disturbance of consciousness in patients with multiple myeloma (MM). However, there have been anecdotal reports of disturbance of consciousness in MM due to hyperammonemia and serum amino acid disturbance without possible causes such as liver failure. A 45-year-old female patient with MM was admitted due to general weakness. On 7th hospital day, she showed somnolence and disorientation. On the assumption of hyperviscosity syndrome, plasma exchange was performed immediately, but no effect. At that time, serum ammonia level was 431㎍/㎗, and serum glycine level was abnormally elevated. This type of serum amino acid disturbance was different from that usually found in chronic liver
disease. After vincristine, adriamycin, and dexamethasone chemotherapy, serum ammonia level was restored to the normal range followed by improved mental status. We report, first in Korea, a case of MM with mental disturbance due to hyperammonemia and serum amino acid disturbance.
Keywords Multiple myeloma; Hyperammonemia; Amino acid disturbance;
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Korean J Hematol 2002; 37(1): 84-87
Published online March 31, 2002
Copyright © The Korean Society of Hematology.
의식장애를 동반한 고암모니아혈증과 혈청 아미노산 이상을 보인 다발성골수종 1례
이재훈, 고윤웅, 맹호영, 정준원, 김진석, 장준호, 김윤재, 최성우, 이승태, 민유홍, 한지숙
연세대학교 의과대학 내과학교실
A Case of Serum Amino Acid Disturbance with Hyperammonemia in a Patient with Multiple Myeloma
Jae Hoon Lee, Yun Woong Ko, Ho Young Maeng, June Won Cheong, Jin Seok Kim, Jun Ho Jang, Yoon Jae Kim, Sung Woo Choi, Seung Tae Lee, Yoo Hong Min, Jee Sook Hahn
Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea
Abstract
Hyperviscosity and hypercalcemia are the common causes of disturbance of consciousness in patients with multiple myeloma (MM). However, there have been anecdotal reports of disturbance of consciousness in MM due to hyperammonemia and serum amino acid disturbance without possible causes such as liver failure. A 45-year-old female patient with MM was admitted due to general weakness. On 7th hospital day, she showed somnolence and disorientation. On the assumption of hyperviscosity syndrome, plasma exchange was performed immediately, but no effect. At that time, serum ammonia level was 431㎍/㎗, and serum glycine level was abnormally elevated. This type of serum amino acid disturbance was different from that usually found in chronic liver
disease. After vincristine, adriamycin, and dexamethasone chemotherapy, serum ammonia level was restored to the normal range followed by improved mental status. We report, first in Korea, a case of MM with mental disturbance due to hyperammonemia and serum amino acid disturbance.
Keywords: Multiple myeloma, Hyperammonemia, Amino acid disturbance,
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