Hypophosphatemia

Hypophosphatemia

Phosphate group chemical structure
Classification and external resources
Specialty endocrinology
ICD-10 E83.3
ICD-9-CM 275.3
DiseasesDB 6503
MedlinePlus 000307
eMedicine med/1135
Patient UK Hypophosphatemia
MeSH D017674

Hypophosphatemia is an electrolyte disturbance in which there is an abnormally low level of phosphate in the blood. The condition has many causes, but is most commonly seen when malnourished patients (especially chronic alcoholics) are given large amounts of carbohydrates, which creates a high phosphorus demand by cells, removing phosphate from the blood (refeeding syndrome).

Because a decrease in phosphate in the blood is sometimes associated with an increase in phosphate in the urine, the terms hypophosphatemia and "phosphaturia" are occasionally used interchangeably; however, this is improper since there exist many causes of hypophosphatemia besides overexcretion and phosphaturia, and in fact the most common causes of hypophosphatemia are not associated with phosphaturia.

Common causes of hypophosphatemia

Primary hypophosphatemia is the most common cause of nonnutritional rickets. Laboratory findings include low-normal serum calcium, moderately low serum phosphate, elevated serum alkaline phosphatase, and low serum 1,25 dihydroxy-vitamin D levels, hyperphosphaturia, and no evidence of hyperparathyroidism.[2]

Other rarer causes include

Pathophysiology

Hypophosphatemia is caused by the following three mechanisms:

Major signs and symptoms

Treatment

Standard intravenous preparations of potassium phosphate are available and are routinely used in malnourished patients and alcoholics. Oral supplementation also is useful where no intravenous treatment is available. Historically one of the first demonstrations of this was in concentration camp victims who died soon after being re-fed: it was observed that those given milk (high in phosphate) had a higher survival rate than those who did not get milk.

Monitoring parameters during correction with IV phosphate[3]

See also

External links

References

  1. O'Brien, Thomas M; Coberly, LeAnn (2003). "Severe Hypophosphatemia in Respiratory Alkalosis" (PDF). Advanced Studies in Medicine 3 (6): 347.
  2. Toy, Girardet, Hormann, Lahoti, McNeese, Sanders, and Yetman. Case Files: Pediatrics, Second Edition. 2007. McGraw Hill.
  3. Shajahan, A., Ajith Kumar, J., Gireesh Kumar, K. P., Sreekrishnan, T. P. and Jismy, K. (2015), Managing hypophosphatemia in critically ill patients: a report on an under-diagnosed electrolyte anomaly. Journal of Clinical Pharmacy and Therapeutics. doi: 10.1111/jcpt.12264
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