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Hypophosphatemia in a Malnourished Child: When Renal Fanconi Syndrome Does Not Stand for Refeeding Syndrome
Author(s) -
Runde Joseph,
RiveraRivera Edgardo,
PompeiiWolfe Cecelia,
Clardy Christopher,
Sentongo Timothy
Publication year - 2019
Publication title -
journal of parenteral and enteral nutrition
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.935
H-Index - 98
eISSN - 1941-2444
pISSN - 0148-6071
DOI - 10.1002/jpen.1177
Subject(s) - hypophosphatemia , fanconi syndrome , urinalysis , medicine , refeeding syndrome , pediatrics , differential diagnosis , tubulopathy , aminoaciduria , intensive care medicine , malnutrition , urine , pathology , kidney
Refeeding syndrome is diagnosed based on the onset of multiple laboratory abnormalities (most commonly hypophosphatemia) and clinical signs in the setting of nutrition rehabilitation of malnourished patients. Because definitions are not uniform, a broad differential diagnosis should always include renal tubular dysfunction. Our report details a 3 year‐old child with undiagnosed renal tubular dysfunction who presented with the clinical picture of refeeding syndrome with refractory electrolyte abnormalities. A diagnosis of renal Fanconi syndrome was made after urinalysis that revealed glucosuria and urine electrolyte losses. Thus, urinalysis can aid in making a positive diagnosis of refeeding syndrome.