A58-year-old woman with a history of hypertension and ane-mia presented to the emergency department with a 7-month history of progressive exhaustion, shortness of breath, palpitations, and dizziness, in addition to a 20-pound weight loss. She was diagnosed with Waldenstrom's macroglobulinemia and placed on dexamethasone. The patient was scheduled for chemotherapy and subsequently discharged a few days later. Three weeks after her initial presentation, she presented to the emergency department with altered mental status. Her husband reported that she had complained of a headache, nausea, and vomiting the day prior to presentation.
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