Open AccessAcute hypophosphataemia and hypokalaemia in a patient starting antiretroviral therapy in Zambia--a new context for refeeding syndrome?
Author(s) -
Christopher Nyirenda,
Isaac Zulu,
Edmond K. Kabagambe,
Shashwatee Bagchi,
Dara Potter,
Claire Bosire,
Zipporah Krishnasami,
Douglas C. Heimburger
Publication year - 2009
Publication title -
bmj case reports
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.231
H-Index - 26
ISSN - 1757-790X
DOI - 10.1136/bcr.07.2008.0469
Subject(s) - medicine , wasting , antiretroviral therapy , context (archaeology) , hypophosphatemia , refeeding syndrome , hypokalemia , intensive care medicine , pediatrics , human immunodeficiency virus (hiv) , malnutrition , immunology , viral load , paleontology , biology
High mortality rates have been reported in the first 90 days of antiretroviral therapy in Zambia and other low-income countries. We report a case of acute hypophosphataemia and hypokalaemia in the first week of antiretroviral therapy in a patient with extreme AIDS wasting. Given its occurrence in an extremely wasted patient, it may be physiologically similar to refeeding syndrome but other causes could be relevant as well. Acute hypophosphataemia may contribute to early antiretroviral therapy associated mortality in low-income countries.