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We present a 45-year-old woman with complex gastrointestinal anatomy leading to short gut syndrome and chronic diarrhea who was admitted with symptomatic severe hypophosphatemia attributed to renal phosphate wasting induced by intravenous iron preparation ferric carboxymaltose. She was maintained on intravenous phosphate replacements. The treatment course was complicated by respiratory illness leading to volume depletion, acute kidney injury, and phosphate nephropathy. She developed chronic kidney disease and underwent kidney transplant. Our case report aims to increase awareness of hypophosphatemia related to ferric carboxymaltose.

Ferric carboxymaltose–induced hypophosphatemia in the Axenfeld-Reiger syndrome