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صفحه اصلي > مقالات علمي > مقالات صفحه 1 > Hyperphosphatemia in a patient with respiratory problems  

Hyperphosphatemia in a Patient with Respiratory Problems


Mihan Pourabdollah,1 Zohreh Mohammad Taheri,1 Forouzan Mohammadi,2 Leila Seifollahi,3 Shahram Sabeti4

1Pediatric Respiratory Diseases Research Center and Chronic Respiratory Diseases Research Center

2Virology Research Center and Mycobacteriology Research Center

3Tobacco Prevention and Control Research Center, Lung Transplantation Research Center, Telemedicine
Research Center, Tracheal Diseases Research Center & Clinical Tuberculosis and Epidemiology Research Center, National Research Institute of Tuberculosis and Lung Disease (NRITLD), Masih Daneshvari Hospital, Shahid Beheshti University of Medical Sciences

4Department of Pathology and Laboratory Medicine, Loghman Hakim Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran

 

Patient: 48-year-old white male. Chief Complaint: Fever and chills, dyspnea, and productive cough. History of Present Illness: The patient was symptomatic for 2 weeks prior to admission and unresponsive to outpatient treatments. The only positive finding on physical examination was a high oral temperatur (38°C). Positive laboratory findings at the time of admission include macrocytic anemia (Hb: 11 g/dL, MCV:110 fl) associated with leucopenia and thrombocytopenia, raised ESR, positive CRP, and most notably, hyperphosphatemia (14.7 mg/dL; reference range: 2.5–5.0 mg/dL) accompanied with normal serum calcium, PTH, and mildly disturbed renal function tests. Chest X-ray and spiral CT scan showed consolidation of the anterior segment of the right upper lobe of the lung. The pneumonia was successfully treated with the antibiotic regimen consisting of ceftazidime, clindamycin, and erythromycin. Because of intractable pancytopenia, the patient underwent a bone-marrow aspiration biopsy that showed increased plasma cells consistent with plasma-cell dyscrasia; immunohistochemical staining of the biopsy specimen revealed λ light chain restriction. Serum total protein and IgG were significantly raised, while IgM and IgA levels were low. The serum β2 –microglobulin level was high, and the urine was positive for Bence-Jones protein. Serum protein electrophoresis (SPE) revealed an M-spike in the gamma-region of the gel
Keywords: plasma cell dyscrasia, multiple myeloma, pseudohyperphosphatemia, hyperglobulinemia

Download ZIP Download PDF                                 Lab Medicine Fall 2012 | Volume 43, Number 6

 

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