Polyclonal Hyperglobulinemia and Spurious Hypophosphatemia
Authors: Amit Malhotra, Prasad R. Koduri
Journal: Annals of Internal Medicine (1999)

Letters17 August 1999Polyclonal Hyperglobulinemia and Spurious HypophosphatemiaAmit Malhotra, MD and Prasad R. Koduri, MDAmit Malhotra, MDCook County Hospital; Chicago, IL 60612 (Malhotra)Cook County Hospital; Chicago, IL 60612 (Koduri)Search for more papers by this author and Prasad R. Koduri, MDCook County Hospital; Chicago, IL 60612 (Malhotra)Cook County Hospital; Chicago, IL 60612 (Koduri)Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-131-4-199908170-00026 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail TO THE EDITOR:Paraproteins may interfere with the measurement of serum inorganic phosphate levels (1-4) and result in pseudohyperphosphatemia or, rarely, pseudohypophosphatemia. In nearly all reported cases, the paraprotein was a monoclonal IgG. We describe a patient in whom spurious hypophosphatemia was caused by polyclonal hyperglobulinemia.A 53-year-old man admitted for management of type 2 diabetes mellitus reported bilateral submandibular salivary gland swelling of 2 years' duration. His total serum protein level was 13.9 g/dL. The serum IgG level was 9160 mg/dL, the IgA level was 165 mg/dL, and the IgM level was 137 mg/dL. Serum protein electrophoresis and immunofixation ...References1. Landowne RA. Immunoglobulin interference with phosphorus and chloride determinations with the Coulter chemistry. Clin Chem. 1979;25:1189-90. CrossrefMedlineGoogle Scholar2. Adler SG, Laidlaw SA, Lubran MM, Kopple JD. Hyperglobulinemia may spuriously elevate measured serum inorganic phosphate levels. Am J Kidney Dis. 1988;11:260-3. CrossrefMedlineGoogle Scholar3. Loghman-Adham M, Walton D, Iverius D, Deiss A, Knight JA, Cheung AK. Spurious hypophosphatemia in a patient with multiple myeloma. Am J Kidney Dis. 1997;30:571-5. CrossrefMedlineGoogle Scholar4. Tipper PL, Miyada DS. Precipitation of multiple myleoma serum in the phosphorus channel of the Beckman Astra. Clin Chem. 1986;32:1597. CrossrefMedlineGoogle Scholar5. Fiske C, Subbarow Y. The colorimetric determination of phosphorus. J Biol Chem. 1925;66:375-400. CrossrefGoogle Scholar Author, Article, and Disclosure InformationAuthors: Amit Malhotra, MD; Prasad R. Koduri, MDAffiliations: Cook County Hospital; Chicago, IL 60612 (Malhotra)Cook County Hospital; Chicago, IL 60612 (Koduri) PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics Cited byInterferences in the measurement of circulating phosphate: a literature reviewSpurious hypophosphatemia associated with monoclonal paraproteinemiaA 90-Year-Old Man With HyperphosphatemiaPROTEIN PRECIPITATION AS A POSSIBLE IMPORTANT PITFALL IN THE CLINICAL CHEMISTRY ANALYSIS OF BLOOD SAMPLES CONTAINING MONOCLONAL IMMUNOGLOBULINS: 2 CASE REPORTS AND A REVIEW OF THE LITERATUREMonoclonal Gammopathy and Spurious Hypophosphatemia 17 August 1999Volume 131, Issue 4Page: 314KeywordsAttentionHypergammaglobulinemiaHyperglobulinemiaInflammationPhosphatesProteinsSalivary glandsSerum proteinsType 2 diabetes ePublished: 15 August 2000 Issue Published: 17 August 1999 Copyright & PermissionsCopyright © 1999 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...