RESUMO
BACKGROUND: Reintroduction of nutrition to the chronically starved patient presents a constellation of metabolic challenges termed "refeeding syndrome." The consequences of this syndrome--principally hypophosphatemia--may be life threatening. Although previously described in the nutritional literature, little information exists on this syndrome written from the perspective of the emergency physician. OBJECTIVES: To promote the early use of prophylactic electrolyte replacement in patients at risk of refeeding syndrome. CASE REPORT: We present the case of a 32-year-old woman with self-inflicted starvation who developed severe hypophosphatemia, hypocalcemia, and hypomagnesemia due to unintended refeeding in the emergency department (ED). CONCLUSIONS: The acute complications of refeeding syndrome may present during a patient's stay in the ED or during the transition from the ED to a critical care area, and thus this syndrome deserves consideration from the moment a starved patient presents to our triage desks.