Thanks for all your responses.
I think the consensus is delayed separation. On closer inspection this sample seems to have been taken on a Friday and received in the lab on Monday. I have no idea why we analysed the sample as our policy is to take out all affected tests if a sample has been left unseparated overnight.
We have recently picked up a case of undiagnosed myeloma causing a spuriously raised phosphate, however, as this is a young, asymptomatic patient whose phosphate and calcium were back to normal on the next sample I think this would be an unlikely explanation.
Thanks
Fiona
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