SynthesisJournal of clinical laboratory analysis2026
Pseudohyperphosphatemia in Multiple Myeloma: A Systematic Review of Case Reports and Case Series.
Synthesis in Journal of clinical laboratory analysis, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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4 authors.
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Abstract
backgroundPseudohyperphosphatemia (PHP) is a laboratory artifact that may occur in patients with multiple myeloma (MM) due to interference from circulating paraproteins in colorimetric phosphate assays. Misinterpretation of this artifact may lead to unnecessary diagnostic evaluation or inappropriate treatment. This systematic review aims to investigate the reported cases of PHP in patients with MM to describe the features used to distinguish it from true hyperphosphatemia.
methodsA comprehensive search of PubMed, Scopus, and Web of Science was conducted in November 2025 to identify English-language case reports and series involving MM patients with hyperphosphatemia. Studies were included if they reported hyperphosphatemia or pseudohyperphosphatemia in patients with multiple myeloma. Data extraction and quality assessment were performed independently by two reviewers using JBI tools.
resultsFourteen studies encompassing 19 patients were included. IgG-kappa was the most frequent paraprotein subtype (n = 16). Most patients exhibited elevated phosphate levels via phosphomolybdate-based assays, which normalized with protein precipitation, dilutional testing, or alternative methods such as atomic emission spectroscopy. Only one case of true hyperphosphatemia was confirmed in the setting of renal dysfunction. Several reports described decreases in measured phosphate levels following chemotherapy and reduction of paraprotein concentrations; however, the available data were limited and insufficient to establish a formal correlation.
conclusionReported cases of hyperphosphatemia in patients with MM are often attributable to PHP caused by paraprotein interference. Further studies are required to better characterize the mechanisms and clinical implications of this laboratory interference.
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