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KMID : 1007020030010010074
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Korean Soceity of Osteroporosis
2003 Volume.1 No. 1 p.74 ~ p.79
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Multiple Myeloma with Pseudohyperphosphatemia
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Kim Yeon-Kyeong
Lee Heoung-Suk
Kim Dae-Jung
Chung Yoon-Sok
Lee Kwan-Woo
Kim Hugh-Chul
Park Il-Joong
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Abstract
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Objectives: Hyperphosphatemia can lead to hypocalcemic tetany, ectopic calcification, secondary hyperparathyroidism and metabolic bone disease. The most common cause of hyperphosphatemia is uremia, hypoparathyroidism, tumor lysis syndrome and so on. Pseudohyperphosphatemia without clinical manifestations of hyperphophatemia can be developed in multiple myeloma without renal failure. We reviewed clinical manifestation and mechanism of pseudohyperphosphatemia with multiple myeloma.
Methods: Six patients of pseudohyperphosphatemia out of 95 patients with multiple myeloma diagnosed at Ajou University Hospital between 1994 and 2003 were analyzed. Serum inorganic phosphate concentrations were checked by phosphomolybdate-ultraviolet method and rechecked after deproteinization processing with 0.8N HClO4 in 3 patients.
Results: There were no clinical features of hyperphosphatemia, and values for serum total calcium concentration, creatinine, 1,25-dihydroxyvitamin D and parathyroid hormone remained within normal limits. In three cases, phosphorus values were normal after removal of serum proteins. Normal values of phosphorus were also obtained with the phosphomolybdate calorimetric assay after reduction of paraprotein levels by chemotherapy.
Conclusion: The pseudohyperphosphatemia was connected to interference of the paraprotein with the chromogenic assay. Physicians should avoid therapy for hyperphosphateima to patient with pseudohyperphosphatemia. The occurrence of pseudohyperphosphatemia should suggest the need for an evaluation to rule out the multiple myeloma.
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KEYWORD
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Pseudohyperphosphatemia, Multiple myeloma, Phosphomolybdate-UV method
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