Hematologists/Physicians Need to Be Aware of Pseudohypercalcemia in Monoclonal Gammopathy: Lessons from a Case Report
We present a patient at risk of misdiagnosis with multiple myeloma due to pseudohypercalcemia. Examinations showed monoclonal protein, 50% monoclonal plasma cells in bone marrow, and hypercalcemia but no osteolytic bone lesions. Follow-up tests revealed pseudohypercalcemia, with elevated total calci...
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| Format: | Article |
| Language: | English |
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Wiley
2024-01-01
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| Series: | Case Reports in Hematology |
| Online Access: | http://dx.doi.org/10.1155/2024/8844335 |
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| author | Svenja F. B. J. Mennens Ellen Van der Spek Janneke Ruinemans-Koerts Marcel M. G. J. Van Borren |
| author_facet | Svenja F. B. J. Mennens Ellen Van der Spek Janneke Ruinemans-Koerts Marcel M. G. J. Van Borren |
| author_sort | Svenja F. B. J. Mennens |
| collection | DOAJ |
| description | We present a patient at risk of misdiagnosis with multiple myeloma due to pseudohypercalcemia. Examinations showed monoclonal protein, 50% monoclonal plasma cells in bone marrow, and hypercalcemia but no osteolytic bone lesions. Follow-up tests revealed pseudohypercalcemia, with elevated total calcium, but normal ionized calcium: a discrepancy due to calcium binding to monoclonal paraprotein (confirmed by laboratory experiments). Accordingly, the patient was diagnosed with smouldering myeloma. After 900 days, the presence of bone lesions prompted the start of treatment for myeloma. Consequently, monoclonal paraprotein levels declined and pseudohypercalcemia dissolved. Hence, ionized calcium should be measured in monoclonal gammopathies to avoid misdiagnosis. |
| format | Article |
| id | doaj-art-82aa4edbd679476db73d96f54e71fb48 |
| institution | Kabale University |
| issn | 2090-6579 |
| language | English |
| publishDate | 2024-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | Case Reports in Hematology |
| spelling | doaj-art-82aa4edbd679476db73d96f54e71fb482025-01-03T01:37:43ZengWileyCase Reports in Hematology2090-65792024-01-01202410.1155/2024/8844335Hematologists/Physicians Need to Be Aware of Pseudohypercalcemia in Monoclonal Gammopathy: Lessons from a Case ReportSvenja F. B. J. Mennens0Ellen Van der Spek1Janneke Ruinemans-Koerts2Marcel M. G. J. Van Borren3Laboratory of Clinical Chemistry and HematologyDepartment of Internal MedicineLaboratory of Clinical Chemistry and HematologyLaboratory of Clinical Chemistry and HematologyWe present a patient at risk of misdiagnosis with multiple myeloma due to pseudohypercalcemia. Examinations showed monoclonal protein, 50% monoclonal plasma cells in bone marrow, and hypercalcemia but no osteolytic bone lesions. Follow-up tests revealed pseudohypercalcemia, with elevated total calcium, but normal ionized calcium: a discrepancy due to calcium binding to monoclonal paraprotein (confirmed by laboratory experiments). Accordingly, the patient was diagnosed with smouldering myeloma. After 900 days, the presence of bone lesions prompted the start of treatment for myeloma. Consequently, monoclonal paraprotein levels declined and pseudohypercalcemia dissolved. Hence, ionized calcium should be measured in monoclonal gammopathies to avoid misdiagnosis.http://dx.doi.org/10.1155/2024/8844335 |
| spellingShingle | Svenja F. B. J. Mennens Ellen Van der Spek Janneke Ruinemans-Koerts Marcel M. G. J. Van Borren Hematologists/Physicians Need to Be Aware of Pseudohypercalcemia in Monoclonal Gammopathy: Lessons from a Case Report Case Reports in Hematology |
| title | Hematologists/Physicians Need to Be Aware of Pseudohypercalcemia in Monoclonal Gammopathy: Lessons from a Case Report |
| title_full | Hematologists/Physicians Need to Be Aware of Pseudohypercalcemia in Monoclonal Gammopathy: Lessons from a Case Report |
| title_fullStr | Hematologists/Physicians Need to Be Aware of Pseudohypercalcemia in Monoclonal Gammopathy: Lessons from a Case Report |
| title_full_unstemmed | Hematologists/Physicians Need to Be Aware of Pseudohypercalcemia in Monoclonal Gammopathy: Lessons from a Case Report |
| title_short | Hematologists/Physicians Need to Be Aware of Pseudohypercalcemia in Monoclonal Gammopathy: Lessons from a Case Report |
| title_sort | hematologists physicians need to be aware of pseudohypercalcemia in monoclonal gammopathy lessons from a case report |
| url | http://dx.doi.org/10.1155/2024/8844335 |
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