Misleading acute hypercalcemia due to hyperlipidemia: a method-dependent error.

Area of Science:

• Clinical Medicine
• Biochemistry

Background:

• Hypercalcemia can present with diverse symptoms, necessitating thorough differential diagnosis.
• Severe hyperlipidemia is a rare but significant factor that can interfere with laboratory assays.

Purpose of the Study:

• To document a case of artifactual hypercalcemia.
• To underscore the importance of considering spurious laboratory results in clinical practice.

Main Methods:

• Case report of a 33-year-old female with fatigue, weight loss, rash, diabetes, and hypertension.
• Laboratory analysis including serum calcium measurement by spectrophotometry, lipid profile, and other biochemical markers.
• Therapeutic intervention with a low-fat diet and gemfibrozil.

Main Results:

• The patient presented with eruptive xanthomas, lipemia retinalis, and laboratory findings of hyperlipidemia, hypercalcemia, anemia, hyperproteinemia, hyperuricemia, and hyperbilirubinemia.
• Following dietary modification and gemfibrozil, serum triglyceride levels decreased, and serum calcium normalized.
• Spectrophotometric measurement of serum calcium was implicated in the artifactual elevation.

Conclusions:

• Artifactual hypercalcemia due to severe hyperlipidemia should be considered in patients with unexplained high calcium levels.
• Prompt management of hyperlipidemia can resolve spurious hypercalcemia.