Lima, Peru - Peruvian authorities threatened sanctions and hefty fines Tuesday as they investigated how pop star Shakira's medical records were leaked following her treatment at a Lima clinic.

The 48-year-old four-time Grammy-winning Colombian singer-songwriter was taken to the emergency room on Saturday for an abdominal condition, forcing her to scrap a blockbuster Sunday show.

Shortly after her brief hospitalization, her medical report appeared on social media, sparking widespread outrage among fans and an official investigation.

A spokeswoman for Peru's national health service watchdog told AFP on Tuesday that investigations were well underway and the clinic could face a fine of up to $430,000.

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"Yesterday [Monday] we were at the clinic, we met with the officials, they have given their explanation, which is confidential," spokeswoman Ruby Cubas told AFP.

The investigation is expected to last 25 days.

The Delgado clinic, where Shakira was treated, said it was also investigating what it called a "serious ethical breach of our code of conduct and regulations governing personal data processing."

"We have already identified and started the sanctioning process against those proven responsible," it said in a statement.

Shakira performed in Lima on Monday night, offering "eternal thanks" to her "beautiful Peruvian audience!! So much love and care you've given me!!"