Spurious hypophosphatemia associated with multiple myeloma.

Endocrine Practice : Official Journal of the American College of Endocrinology and the American Association of Clinical Endocrinologists
J A Caras

Abstract

To report on the phenomenon of spurious hypophosphatemia associated with multiple myeloma. A case report is presented, and the pertinent published literature is reviewed. The mechanisms by which multiple myeloma can cause both true and false hypophosphatemia are discussed, as are methods by which the important distinction between these conditions can be made. At the time of surgical treatment of a hip fracture, an 80-year-old man with a history of multiple myeloma was found to have hypophosphatemia. Despite intravenous administration of large amounts of phosphate, the low phosphate values persisted. Only when a blood sample was submitted to another laboratory that used a different technique for determining phosphate was a normal phosphate level reported. In patients with multiple myeloma, the myeloma protein can cause biochemical interference with certain phosphate assays, which could lead to false results. This phenomenon should be considered in such patients in order to avoid inappropriate and potentially dangerous phosphate replacement therapy.

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Citations

Jul 2, 2011·QJM : Monthly Journal of the Association of Physicians·Z Mao, A C M Ong
Oct 19, 2010·American Journal of Kidney Diseases : the Official Journal of the National Kidney Foundation·Shachi Lovekar, Joline L T Chen
Jun 13, 2006·Nephrology, Dialysis, Transplantation : Official Publication of the European Dialysis and Transplant Association - European Renal Association·Piero StrattaGiorgio Bellomo
Nov 30, 2019·Drug Safety : an International Journal of Medical Toxicology and Drug Experience·Efstathia MegapanouGeorge Liamis
Jun 19, 2020·Clinical Chemistry and Laboratory Medicine : CCLM·Valentina MolinarisPietro B Faré
Nov 28, 2020·AACE Clinical Case Reports·Lawrence Wen WuKyaw K Soe
Jan 30, 2021·Case Reports in Endocrinology·Paula JeffsNadyeschka Rivera-Santana

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