Frequency of hypercalcemia in patients of multiple myeloma in Karachi.

OBJECTIVE

To determine the frequency of hypercalcemia and skeletal abnormalities in multiple myeloma patients.

DESIGN

Cross-sectional study.

PLACE AND DURATION OF STUDY

Study was conducted from January 1999 to July 2004 at the Aga Khan University Hospital (AKUH), a tertiary care hospital in Karachi, Pakistan.

PATIENTS AND METHODS

Medical records of all the diagnosed cases of multiple myeloma at their presentation to hospital were reviewed. The frequency of hypercalcemia and skeletal lesions was calculated. Independent sample t-test and chi-square test as appropriate, was applied to calculate the difference in parameters between normocalcemic and hypercalcemic patients.

RESULTS

Sixty-seven percent patients were males and 33% were females. The mean age was 61-/+11 years. Of the 105 study patients, 51.2% had hypercalcemia (S.Ca >2.64 mmol/l). Radiological survey showed different levels of skeletal involvement in 89.8% of patients. It was also found that 94.3% of hypercalcemic patients had skeletal lesions, out of which 20% had advanced (stage 3) bone lesions. Also noteworthy was the fact that 84.6% of normocalcemic patients had mild /moderate (stage 1 and 2) skeletal lesions.

CONCLUSION

There was higher frequency of hypercalcemia in multiple myeloma patients in this series. Skeletal lesions were present in significant number of these patients. It is suggested that patients with multiple myeloma should be checked for serum corrected calcium and radiological surveys be included in routine workup for early detection and prevention of hypercalcemia and skeletal lesions.