Pulmonary Calcification in a Patient with Multiple Myeloma

A patient with multiple myeloma and hypercalcemia was treated with intravenous sodium sulfate and prolonged oral sodium phosphate. She subsequently developed extensive metastatic calcification in the lungs, alveolar-capillary block and severe respiratory distress. The probable mechanism of phosphate and sulfate induced soft tissue calcification in hypercalcemia is reviewed and caution is urged in the administration of phosphate as a hypocalcemic agent.