Delayed Diagnosis and Treatment of Multiple Myeloma Complicated with Refractory Hypercalcemia and Literature Review
MAO Xuehan
MO Zheng
LI Jiao
LI Lihong
ZHANG Ai
HUANG Yuehua
Abstract：Objective To explore the causes and preventive measures of delayed diagnosis and treatment in patients with multiple myeloma complicated with refractory hypercalcemia.Methods The clinical data of a newly diagnosed multiple myeloma patient with refractory hypercalcemia in June 2021 who achieved disease remission after systemic therapy were retrospectively analyzed.Results A 73-year-old female patient was diagnosed with multiple myeloma due to anemia,foamy urine and hypercalcemia as initial manifestations,based on bone marrow puncture and other related examinations.Hypercalcemia was considered to be related to multiple myeloma.After receiving systemic anti-myeloma therapy,the patient's myeloma was in remission,but he still had persistent hypercalcemia.Further screening showed that the intact parathyroid hormone was significantly elevated and that a hypoechoic nodule was found below the lower pole of the right parathyroid lobe,so the patient was diagnosed with primary hyperparathyroidism.The diagnosis was delayed for 15 months.The family declined surgical treatment and the patient was given Zoledronic Acid/Denosumab to reduce blood calcium,resulting in a sustained stable state of the disease.Conclusion Although hypercalcemia is one of the common onset manifestations of multiple myeloma,in clinical practice,when we receive patients with unexplained hypercalcemia of primary disease,we need to make the corresponding differential diagnosis to avoid missing other possible combined diseases.
Keywords：Multiple myelomaHypercalcemiaPrimary hyperparathyroidismMisdiagnosisDifferential Diagnosis
Publication Date：2025-07-28
Online Publishing Date：2025-08-15(First online date of this platform, not the publication date of the document)
Pages：5( 15-19 )