Pseudohypophosphatemia In A Patient With Multiple Myeloma

Lawrence Wen Wu, MD; Tak-Shun Choi, MD; Monica Barbosa, MD; Hyemi Chong, MD; Ashley Garland Wallace Wu, MD; Kyaw K. Soe, MD

AACE Clinical Case Reports (Nov 2020)

Pseudohypophosphatemia In A Patient With Multiple Myeloma

Lawrence Wen Wu, MD,
Tak-Shun Choi, MD,
Monica Barbosa, MD,
Hyemi Chong, MD,
Ashley Garland Wallace Wu, MD,
Kyaw K. Soe, MD

Affiliations

Lawrence Wen Wu, MD: From the Department of Medicine, Johns Hopkins Hospital, Baltimore, Maryland
Tak-Shun Choi, MD: Department of Pathology, University of Texas Southwestern Medical Center and VA North Texas Health Care System, Dallas, Texas
Monica Barbosa, MD: Division of General Internal Medicine, University of Texas Southwestern Medical Center and VA North Texas Health Care System, Dallas, Texas
Hyemi Chong, MD: Division of General Internal Medicine, University of Texas Southwestern Medical Center and VA North Texas Health Care System, Dallas, Texas
Ashley Garland Wallace Wu, MD: Department of Pediatrics, Johns Hopkins Hospital, Baltimore, Maryland
Kyaw K. Soe, MD: Address correspondence to Dr. Kyaw K. Soe, Division of Endocrinology, Diabetes and Lipid Metabolism, Department of Medicine, Dallas VA Medical Center, 4500 South Lancaster Road, Dallas, TX 75216.; Division of Endocrinology, Department of Medicine, University of Texas Southwestern Medical Center and VA North Texas Health Care System, Dallas, Texas.

Journal volume & issue: Vol. 6, no. 6
pp. e334 – e337

Abstract

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ABSTRACT: Objective: To discuss the diagnosis and management of paraprotein interference in the setting of multiple myeloma (MM). Methods: We discuss the evaluation of hypophosphatemia in a patient with MM and present a review of the relevant literature. Results: Our patient, who had a history of MM, was found to have persistently undetectable serum phosphate which did not respond to aggressive phosphate replacement. His clinical condition was not consistent with severe phosphate depletion and hence paraprotein interference secondary to MM was suspected. Re-analyzation of samples on a different machine showed normal serum inorganic phosphate levels. Conclusion: Paraprotein interference from MM causing pseudohypophosphatemia can be overlooked and lead to unnecessary treatment. Recognition of this phenomenon is important to all clinicians, especially in light of potential complications of unnecessary treatment. Abbreviation: MM multiple myeloma

Published in AACE Clinical Case Reports

ISSN: 2376-0605 (Online)
Publisher: Elsevier
Country of publisher: United States
LCC subjects: Medicine: Internal medicine: Specialties of internal medicine: Diseases of the endocrine glands. Clinical endocrinology
Website: https://www.journals.elsevier.com/aace-clinical-case-reports

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