An unusual cause of anemia and encephalopathy

Abstract

The authors present here an interesting case of recent onset anemia that was associated with an encephalopathy of the unusual cause.Although severe anemia can theoretically result in anemic hypoxia and can then lead to hypoxic encephalopathy, it is not a primary cause of encephalopathy. More frequently anemia can contribute together with other multiple causes of encephalopathy, such as infections, metabolic abnormalities, trauma, hepatic dysfunction, hypertension, toxins.

Hypercalcemic Encephalopathy as an Initial Presentation of Multiple Myeloma

“…AMS in a patient with multiple myeloma can be attributed to uremia, hypercalcemia, hyperviscosity, increased serum ammonia, leptomeningeal myelomatosis (LMM), and intraparenchymal plasmacytoma ( Table 1). ere are few reports describing altered sensorium as a first presentation of multiple myeloma [5,[8][9][10][11]. e common causes of altered sensorium in these reports are direct neurological involvement due to myeloma and uremia ( Table 2).…”

“…However, hypercalcemic encephalopathy as an initial presentation is rarely reported in the literature. e altered mental status (AMS) in multiple myeloma can be secondary to hypercalcemia, hyperviscosity, uremia, and hyperammonemia [2][3][4][5]. Here, we report an 84-year-old female presented in the emergency department with acute onset altered sensorium which on evaluation was diagnosed as hypercalcemic encephalopathy due to multiple myeloma.…”

A case of fatal hyperammonaemic encephalopathy in a patient with end-stage Multiple Myeloma treated with daratumumab

“…Also in other case series, VCd is often reported. 10 Nevertheless, the prognosis of this condition in MM remains poor despite chemotherapy.…”