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Hypercalcemia and Normal Ionized Serum Calcium in a Case of Myelomatosis

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▸ Requests for reprints should be addressed to Dr. Folke Lindgärde, Department of Medicine, University of Lund, Malmö General Hospital, S-214 01 Malmö, Sweden.

Ann Intern Med. 1973;78(3):396-399. doi:10.7326/0003-4819-78-3-396
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In a patient with myelomatosis and persistent increase of total serum calcium but without clinical hypercalcemic symptoms, the serum ionized calcium was normal. In contrast, ionized calcium was elevated in all serums from 14 other patients with hypercalcemic myelomatosis. The increased nonionized serum calcium in our patient was explained by the presence of a calcium-binding IgG myeloma globulin. Hypercalcemia caused by calcium-binding myeloma globulins does not seem to have been described earlier.





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