Electrolyte Blood Press.  2007 Dec;5(2):131-135. 10.5049/EBP.2007.5.2.131.

Pseudohyperphosphatemia in a Patient with Multiple Myeloma

Affiliations
  • 1Department of Internal Medicine, Hanyang University Guri Hospital, Guri, Korea. cardion@hanyang.ac.kr
  • 2Department of Laboratory Medicine, Hanyang University Guri Hospital, Guri, Korea.

Abstract

Hyperphosphatemia is an unusual manifestation in patients with multiple myeloma without a significantly reduced glomerular filtration rate. Serum phosphate may be falsely elevated when a large amount of paraproteins is present in the serum, because ultraviolet light absorbance is elevated with the phosphomolybdate ultraviolet assay, which is most commonly used for serum phosphate measurement. This pseudohyperphosphatemia can be confirmed by deproteinization of the serum of patients. We report a case of multiple myeloma presenting with spurious hyperphosphatemia revealing pseudohyperphosphatemia by deproteinization of serum using sulfosalicylic acid.


MeSH Terms

Glomerular Filtration Rate
Humans
Hyperphosphatemia
Multiple Myeloma*
Paraproteinemias
Paraproteins
Ultraviolet Rays
Paraproteins

Figure

  • Fig. 1 Relationship between serum globulin and phosphate in the multiple myeloma patient with pseudohyperphosphatemia.


Reference

1. Mandry JM, Posner MR, Tucci JR, Eil C. Hyperphosphatemia in multiple myeloma due to a phosphate-binding immunoglobulin. Cancer. 1991; 68:1092–1094. PMID: 1913479.
Article
2. McCloskey EV, Galloway J, Morgan MA, Kanis JA. Pseudohyperphosphataemia in multiple myeloma. BMJ. 1989; 299:1381–1382. PMID: 2513970.
Article
3. Stratta P, Canavese C, Quaglia M, Lazzarich E, Morellini V, Brustia M, Bardone B, Bellomo G. A patient with unexplained hyperphosphataemia. Nephrol Dial Transplant. 2006; 21:2664–2666. PMID: 16766547.
Article
4. Levey AS, Greene T, Kusek JW, Beck GJ. MDRD Study Group. A simplified equation to predict GFR from serum creatinine. [Abstract]. J Am Soc Nephrol. 2000; 11:155.
5. Kim KS, Kim DU, Lee WS, Chung WS. Pseudohyperphosphatemia in multiple myeloma. Korean J Hematol. 1994; 29:351–355.
6. Barutcuoglu B, Parildar Z, Mutaf I, Habif S, Bayindir O. Spuriously elevated inorganic phosphate level in a multiple myeloma patient. Clin Lab Haematol. 2003; 25:271–274. PMID: 12890170.
7. Sonnenblick M, Eylath U, Brisk R, Eldad C, Hershko C. Paraprotein interference with colorimetry of phosphate in Serum of some patients with multiple myeloma. Clin Chem. 1986; 32:1537–1539. PMID: 3731447.
Article
8. Han JY, Lee JH, Choi BG, Moon YS, Jin SW, Han WH, Kim YG, Hong YS, Kim HK, Kim BK, Lee KS, Kim DJ. Clinical Spectrums of Pseudohyperphosphatemia in Multiple Myeloma. Korean J Med. 1996; 51:157–159.
9. Marcu CB, Hotchkiss M. Pseudohyperphosphatemia in a patient with multiple myeloma. Conn Med. 2004; 68:71–72. PMID: 15007869.
10. Oren S, Feldman A, Turkot S, Lugassy G. Hyperphosphatemia in multiple myeloma. Ann Hematol. 1994; 69:41–43. PMID: 8061106.
Article
11. Cheikhrouhou Abdelmoula L, Amira C, Chaabouni L, Kchir MM, Zouari R. Hyperphosphatemia in multiple myeloma. Joint Bone Spine. 2003; 70:541–542. PMID: 14667570.
Article
12. Adler SG, Laidlaw SA, Lubran MM, Kopple JD. Hyperglobulinemia may spuriously elevate measured serum inorganic phosphate levels. Am J Kidney Dis. 1988; 11:260–263. PMID: 3125742.
Article
13. Teppo AM. Immunoturbidimetry of albumin and immunoglobulin G in urine. Clin Chem. 1982; 28:1359–1361. PMID: 6804127.
Article
Full Text Links
  • EBP
Actions
Cited
CITED
export Copy
Close
Share
  • Twitter
  • Facebook
Similar articles
Copyright © 2024 by Korean Association of Medical Journal Editors. All rights reserved.     E-mail: koreamed@kamje.or.kr