Severe and prolonged hypophosphatemia after intravenous iron administration in a malnourished patient.
Eur J Clin Nutr
; 68(4): 531-3, 2014 Apr.
Article
in En
| MEDLINE
| ID: mdl-24569537
ABSTRACT
Malnutrition may result in a phosphate-deficient state owing to a chronically insufficient phosphate intake. Concomitant iron deficiency is common and often supplemented by the intravenous route. It is not widely recognized that some parenteral iron formulations can induce hypophosphatemia. Herein we report a case of a severe and symptomatic hypophosphatemia (0.18 mM, normal range 0.8-1.4 mM) associated with an inappropriately reduced tubular reabsorption of phosphate (33%, norm >95%) in a malnourished patient with anorexia/bulimia who received 2 × 500 mg iron carboxymaltose (FCM) intravenously. Despite intravenous and oral phosphate supplements, it required 2 months to achieve a normal serum phosphate level. Our case demonstrates that in a chronically malnourished and phosphate-deficient state intravenous FCM could potentially be dangerous. If this form of iron application cannot be avoided, phosphate supplementation before and after iron infusion as well as close monitoring of phosphate levels are needed.
Full text:
1
Database:
MEDLINE
Main subject:
Ferric Compounds
/
Hypophosphatemia
/
Malnutrition
/
Maltose
Type of study:
Diagnostic_studies
/
Etiology_studies
Language:
En
Journal:
Eur J Clin Nutr
Year:
2014
Type:
Article
Affiliation country:
Switzerland