Work

A Wolf in Sheep’s Clothing: Pseudohypobicarbonatemia in a Patient With Multiple Myeloma

Year: 2025

Type: article

Abstract: There are multiple methods to measure serum bicarbonate level which is crucial for diagnosis and management of acid-base disturbances. The most common method is directly measuring the total serum carbon dioxide (CO2) concentration in a basic metabolic panel. Another method is by indirect calculation of the bicarbonate concentration via the Henderson-Hasselbalch equation using the measured pH and partial pressure of CO2 (pCO2) in plasma. Multiple confounders can cause discrepancies in the measured bicarbonate in each method, such as increased concentration of serum lipids or proteins, that can alter measurement assays, leading to spuriously low serum bicarbonate values. In our case, we present a patient with falsely low reported bicarbonate levels in the setting of increased paraproteins due to multiple myeloma.

Source: Cureus

DOI: 10.7759/cureus.80782

Authors: Ziad Alahmadi, Zain Haq, Ami Patel, Joshua D King

Institutions: Umm al-Qura University, Samaritan Health Services, University of Maryland Medical Center

Language: English

Topic: Clinical Laboratory Practices and Quality Control

Subfield: Physiology

Field: Medicine

Domain: Health Sciences

SDG: Good health and well-being

Open Access status: diamond

OpenAlex ID: W4408559217