Multiple myeloma with hypercalcemia and chloride resistant metabolic alkalosis.

Hala Alshayeb, Vikul Patel, Adnan Naseer, Therese A. Mangold, Barry Wall

Research output: Contribution to journalArticle

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Abstract

This report describes a novel presentation of chloride resistant metabolic alkalosis in a patient with hypercalcemia related to Multiple Myeloma (MM). A 51-year-old male with newly diagnosed MM presented with widespread skeletal involvement, calcium (Ca(+2)) of 18 mg/dL, phosphorous (PO4) of 6 mg/dL, serum bicarbonate (HCO3) of 37 mEq/L, and serum creatinine (Cr) of 2.6 mg/dL Other causes of metabolic alkalosis such as vomiting, diuretics, alkali ingestion, mineralocorticoid excess and hypokalemia were excluded. Hypercalcemia and metabolic alkalosis were only partially corrected after rehydration, calcitonin and steroids. Subsequent treatment with zoledronic acid resulted in resolution of hypercalcemia and correction of metabolic alkalosis.The chloride resistant component of metabolic alkalosis was most likely related to extensive release of Ca(+2), carbonate and phosphate from bone by activated osteoclasts with inhibited osteoblastic activity. The additional reduction in glomerular filtration rate due to MM, contributed to a triad mimicking Calcium-Alkali syndrome.

Original languageEnglish (US)
Pages (from-to)47-49
Number of pages3
JournalTennessee medicine : journal of the Tennessee Medical Association
Volume104
Issue number9
StatePublished - Oct 1 2011

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Alkalosis
Hypercalcemia
Multiple Myeloma
Chlorides
zoledronic acid
Alkalies
Calcium
Mineralocorticoids
Hypokalemia
Fluid Therapy
Carbonates
Calcitonin
Osteoclasts
Bicarbonates
Serum
Glomerular Filtration Rate
Diuretics
Vomiting
Creatinine
Eating

All Science Journal Classification (ASJC) codes

  • Medicine(all)

Cite this

Multiple myeloma with hypercalcemia and chloride resistant metabolic alkalosis. / Alshayeb, Hala; Patel, Vikul; Naseer, Adnan; Mangold, Therese A.; Wall, Barry.

In: Tennessee medicine : journal of the Tennessee Medical Association, Vol. 104, No. 9, 01.10.2011, p. 47-49.

Research output: Contribution to journalArticle

Alshayeb, Hala ; Patel, Vikul ; Naseer, Adnan ; Mangold, Therese A. ; Wall, Barry. / Multiple myeloma with hypercalcemia and chloride resistant metabolic alkalosis. In: Tennessee medicine : journal of the Tennessee Medical Association. 2011 ; Vol. 104, No. 9. pp. 47-49.
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