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Spurious Hyperphosphatemia in a Case of Multiple Myeloma |
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| Authors: | Sutirtha Chakraborty Susruta Sen Debkishore Gupta Sidhartha Sankar Ghosh Prasad Sawant Mandrita Das |
| Institution: | 1. Department of Biochemistry, Peerless Hospital & B K Roy Research Centre, Kolkata, 700094, West Bengal, India 2. Department of Biochemistry, Calcutta Medical Research Institute, Kolkata, India 3. Department of Microbiology, Peerless Hospital & B K Roy Research Centre, Kolkata, India 4. Mumbai, India |
| Abstract: | A 50 year old male was admitted in our hospital with anemia and impaired renal function. He was subsequently found to have extremely elevated serum phosphate level (24 mg/dL, reference interval: 2.5–4.5 mg/dL) with normal serum calcium when assayed on a Beckman Coulter AU 480® analyser. Clinico-biochemical discrepancy led to the suspicion of spurious hyperphosphatemia. Serum total protein was grossly elevated with gross reversal of albumin to globulin ratio. Serum electrophoresis revealed a large M band and was confirmed as Ig G-Kappa type on immunofixation. Subsequently a bone marrow aspiration biopsy confirmed the diagnosis of multiple myeloma. The patient serum was then reassayed for phosphate on a Vitros® 250 Dry Chemistry platform and the result was within normal reference interval. Paraproteinemias are a common cause of analytical interference in clinical biochemistry laboratories and as multilayered film technology platforms like Vitros® assay most routine analytes on a protein free filtrate they are unaffected by paraprotein interference. Clinically discordant patient results should always be interpreted keeping such interferences in mind. |
| Keywords: | Hyperphosphatemia Paraprotein Multiple myeloma Interference |
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