Hypophosphatemia in Patients With Multiple Myeloma
Ivan Cancarevic1, Usman Ilyas1, Mahmoud Nassar2
1Internal Medicine, Icahn School of Medicine at Mount Sinai, Queens Hospital Center, New York, USA.
Cureus
|June 21, 2023
Summary
Hypophosphatemia, a common electrolyte issue in multiple myeloma patients, has diverse causes including tumor effects and medications. Understanding these triggers aids in early detection and management.
Area of Science:
- Nephrology
- Oncology
- Endocrinology
Background:
- Hypophosphatemia is a frequent electrolyte disorder, particularly in cancer patients, often linked to poor outcomes.
- Phosphorus homeostasis involves complex interactions between parathyroid hormone (PTH), fibroblast growth factor-23 (FGF-23), and vitamin D.
- Clinical presentation of hypophosphatemia is nonspecific, leading to diagnostic delays.
Purpose of the Study:
- To review the causes and consequences of hypophosphatemia in multiple myeloma patients.
- To elucidate the mechanisms underlying hypophosphatemia in this specific patient population.
Main Methods:
- A narrative literature review was conducted.
- Relevant articles were identified by searching the PubMed database for hypophosphatemia in multiple myeloma.
Main Results:
- Multiple myeloma patients exhibit various hypophosphatemia causes, including tumor-induced osteopenia and Fanconi syndrome.
- Medications like bisphosphonates and novel myeloma therapies can precipitate hypophosphatemia through direct effects or by altering calcium and PTH levels.
- Light chains and certain drugs can induce Fanconi syndrome, causing renal phosphorus wasting.
Conclusions:
- Identifying specific triggers for hypophosphatemia in multiple myeloma is crucial for targeted screening.
- Understanding the diverse mechanisms aids clinicians in proactive patient management and monitoring.
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