Open AccessRecurrent severe hypophosphatemia following intravenous iron administration
Author(s) -
Nataatmadja Melissa Stephanie,
Francis Ross
Publication year - 2020
Publication title -
clinical case reports
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.21
H-Index - 9
ISSN - 2050-0904
DOI - 10.1002/ccr3.2595
Subject(s) - hypophosphatemia , medicine , osteomalacia , wasting , fibroblast growth factor 23 , toxicity , fibroblast growth factor , phosphate , gastroenterology , endocrinology , vitamin d and neurology , calcium , parathyroid hormone , biochemistry , receptor , chemistry
Key Clinical Message Hypophosphatemia postintravenous iron is frequent but under‐recognized. If prolonged or recurrent, it can cause osteomalacia. The likely mechanisms are direct toxicity to proximal tubular cells causing phosphate wasting, elevated Fibroblast growth factor‐23 (FGF‐23), and reduced 1,25‐dihydroxyvitamin D (1,25(OH) 2 D). Hypophosphatemia may be severe and persist for months, necessitating phosphate replacement until normalization of serum levels occurs.