Pseudohyperphosphatemia in a patient with relapsed multiple myeloma after bone marrow transplantation: A case report

Kritmetapak, Kittrawee; Dumrongsukit, Sophon; Jinchai, Jittirat; Wongprommek, Panibud

doi:10.1002/ccr3.2264

Cited by 5 publications

(2 citation statements)

References 30 publications

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“…They suggested the preparation of a blood sample with a protein-free filtrate prepared with trichloroacetic acid. 4 Pseudo-hyperphosphatemia has been reported in the past in patients with multiple myeloma 5,6 and it has been mostly associated with a laboratory artifact. The most commonly used technique to measure serum phosphate is by phosphomolybdate ultraviolet (UV) assay, which relies on UV absorption of ammonium phosphomolybdate complexes in the presence of sulfuric acid.…”

Section: Discussionmentioning

confidence: 99%

A rare case of severe hyperphosphatemia

Bonilla

Pariswala

Ali³

et al. 2022

Journal of Onco-Nephrology

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Hyperphosphatemia is commonly associated with kidney failure. However, many other etiologies should be considered, and include increase tubular reabsorption of phosphate, endogenous or exogenous phosphate loads and transcellular shift. We present a case of a 71-year-old male with a medical history of anemia and constipation who presented to our hospital for abdominal pain. Initial Laboratory evaluation demonstrated a severely elevated serum phosphate level, calcium level within the normal limit, and a mild elevation of serum creatinine. He underwent a bone marrow biopsy confirming a diagnosis of IgG-kappa-type Multiple Myeloma (MM). There is an established association between electrolyte abnormalities in patients with hematological malignancies, however, MM is rarely associated with hyperphosphatemia. Spurious electrolyte abnormalities present a challenge for clinicians, pseudo-hyperphosphatemia in patients with MM has been associated with laboratory artifacts. Our patient did not have clinical characteristics of hyperphosphatemia, after the new diagnosis of multiple myeloma and ruling out other etiologies leading to hyperphosphatemia, the elevated phosphorous level was attributed to a spurious etiology.

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Section: Discussionmentioning

confidence: 99%

A rare case of severe hyperphosphatemia

Bonilla

Pariswala

Ali³

et al. 2022

Journal of Onco-Nephrology

View full text Add to dashboard Cite

show abstract

“…A review of the literature identified total bilirubin, 2–4 HDL cholesterol 3,4 and phosphate 5 as additional Roche assays known to be affected by interference from paraproteins. Other assays reported to be affected by interference include albumin (bromcresol green), 8 urate (uricase), 6 calcium (arsenazo-III), 7 iron (ferrozine) 9 and total protein (biuret).…”

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confidence: 99%