Korean J Hematol 2003; 38(1):
Published online March 31, 2003
© The Korean Society of Hematology
다발성골수종에서 혈청내 특정 아미노산들의 농도변화를 동반한 고암모니아혈성 뇌병증 1례
서유미, 엄현석, 김장균, 강인중, 이승헌, 한치화, 이제훈
가톨릭대학교 의과대학 내과학교실,
가톨릭대학교 의과대학 진단검사의학교실
A Case of Hyperammonemic Encephalopathy with Serum Amino Acid Alteration in Multiple Myeloma
Disturbance of consciousness in patients with multiple myeloma is usually related with uremia, hypercalcemia or hyperviscosity syndrome. Currently, hyperammonemic encephalopathy which accompanies characteristic change of amino acid levels in pheripheral blood has been reported as a rare cause of mental change in multiple myeloma. We experienced a case of hyperammonemic encephalopathy in a 60-year-old man with multiple myeloma who had shown transient response to the combination chemotherapy with
melphalan and prednisolone. Measurement of amino acid concentrations in peripheral blood revealed high glycine/tyrosine ratio and low Fisher ratio. In spite of conventional treatment on hyperammonemic encephalopathy, he died of disease progression without improvement of consciousness level.
Keywords Multiple myeloma; Hyperammonemia; Amino acid alteration;
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Korean J Hematol 2003; 38(1): 64-67
Published online March 31, 2003
Copyright © The Korean Society of Hematology.
다발성골수종에서 혈청내 특정 아미노산들의 농도변화를 동반한 고암모니아혈성 뇌병증 1례
서유미, 엄현석, 김장균, 강인중, 이승헌, 한치화, 이제훈
가톨릭대학교 의과대학 내과학교실,
가톨릭대학교 의과대학 진단검사의학교실
A Case of Hyperammonemic Encephalopathy with Serum Amino Acid Alteration in Multiple Myeloma
Yu Mi Seo, Hyeon Seok Eom, Jang Kyun Kim, In Jung Kang, Seung Hun Lee, Chi Wha Han, Je Hoon Lee
Department of Internal Medicine, Laboratory Medicine, Our Lady of Mercy Hospital, The Catholic University of Korea College of Medicine Seoul, Korea
Abstract
Disturbance of consciousness in patients with multiple myeloma is usually related with uremia, hypercalcemia or hyperviscosity syndrome. Currently, hyperammonemic encephalopathy which accompanies characteristic change of amino acid levels in pheripheral blood has been reported as a rare cause of mental change in multiple myeloma. We experienced a case of hyperammonemic encephalopathy in a 60-year-old man with multiple myeloma who had shown transient response to the combination chemotherapy with
melphalan and prednisolone. Measurement of amino acid concentrations in peripheral blood revealed high glycine/tyrosine ratio and low Fisher ratio. In spite of conventional treatment on hyperammonemic encephalopathy, he died of disease progression without improvement of consciousness level.
Keywords: Multiple myeloma, Hyperammonemia, Amino acid alteration,
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