Summary
We report three cases of IgG kappa multiple myeloma with pseudohyperphosphatemia. The patients' serum calcium levels were normal, and the hyperphosphatemia was not related to impaired renal function. No hypoparathyroidism was found, and no exogenous phosphate preparation had been given. Since the hyperphosphatemia was of no obvious clinical or physiological significance, as evidenced by normal serum levels of 1,25 dihydroxy vitamin D3, it was diagnosed as spurious and was connected to interference of the paraprotein with the chromogenic assay. In two of the patients major fluctuations in serum phosphate levels were seen, induced by the changes in globulin and paraprotein levels that occurred during therapy and relapse.
This is a preview of subscription content, log in via an institution to check access.
Similar content being viewed by others
References
Defronzo RA, Cooke CP, Wright JR et al. (1978) Renal function in patients with multiple myeloma. Medicine 57:151–166
Kyle RA (1975) Multiple myeloma: review of 869 cases. Mayo Clin Proc 50:29–40
Young DS, Pestaner LC, Gibberman V (1975) Effects of drugs on clinical laboratory tests. Clin Chem 21:342D
Leehey DJ, Daugirdas JT, Ing TS, Reid RW (1985) Spurious hyperphosphatemia due to hyperlipidemia. Arch Intern Med 145:743–744
Jarchowsky I, Beitner H, Plavnick L (1991) Spurious hyperphosphatemia in multiple myeloma. Harefuah 121:515–516
Busse JC, Gelbard MA, Byrenes JJ, Hellman R, Vaamonde CA (1987) Pseudohyperphosphatemia and dysproteinemia. Arch Intern Med 147:2045–2046
Petterson T, Hortling L, Teppo AM, Toetterman KJ, Fyhrquist F (1987) Phosphate binding by a myeloma protein. Acta Med Scand 222:89–91
Sonnenblick M, Eylath U, Brisk R, Eldad C, Hershko C (1986) Paraprotein interference with colorimetry of phosphate in serum of some patients with multiple myeloma. Clin Chem 32:1537–1539
Landowne RA (1979) Immunoglobulin interference with phosphorus and chloride determinations with the Coulter chemistry (letter). Clin Chem 25:1189–1190
Mandry JM, Posner MR, Tucci JR, Eil C (1991) Hyperphosphatemia in multiple myeloma due to a phosphate-binding immunoglobulin. Cancer 68:1092–1094
Adler SG, Laidlaw SA, Lubran MM, Kopple JD (1988) Hyperglobulinemia may spuriously elevate measured serum inorganic phosphate levels. Am J Kidney Dis 11:260–263
Savage D, Garrett TJ (1986) Multiple myeloma masquerading as metastatic breast cancer. Cancer 57:923–924
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
Oren, S., Feldman, A., Turkot, S. et al. Hyperphosphatemia in multiple myeloma. Ann Hematol 69, 41–43 (1994). https://doi.org/10.1007/BF01757346
Received:
Accepted:
Issue Date:
DOI: https://doi.org/10.1007/BF01757346