Hypophosphatemia

Etiology

Inadequate Dietary Intake

  • Ethanol Abuse (see Ethanol, [[Ethanol]])

Intracellular Shift

Drug/Toxin

  • Denosumab (Xgeva, Prolia) (see Denosumab, [[Denosumab]])
  • Sorafenib (Nexavar) (see Sorafenib, [[Sorafenib]])
  • White Phosphorus Toxicity (see White Phosphorus, [[White Phosphorus]])
    • Epidemiology: associated with systemic toxicity

Diagnosis

  • xxx

Clinical Manifestations

General Comments

  • Symptoms Usually Occur at Serum Phosphate Levels <1

Cardiovascular Manifestations

Hematologic Manifestations

  • Decreased Leukocyte Function
  • Hemolysis (see Hemolytic Anemia, [[Hemolytic Anemia]])
  • Platelet Dysfunction (see Coagulopathy, [[Coagulopathy]]): likely due to impaired platelet aggregation

Neurologic Manifestations

  • Altered Mental Status/Delirium (see Delirium, [[Delirium]])
  • Anxiety (see Anxiety, [[Anxiety]])
  • Ballismus (see Ballismus, [[Ballismus]])
  • Dysphagia (see Dysphagia, [[Dysphagia]])
  • Dysarthria (see Dysarthria, [[Dysarthria]])
  • Irritability
  • Muscle Cramps
  • Parasthesias (see Parasthesias, [[Parasthesias]])
  • Rhabdomyolysis (see Rhabdomyolysis, [[Rhabdomyolysis]])
  • Seizures (see Seizures, [[Seizures]])
  • Weakness

Other Manifestations

  • Osteomalacia

Treatment

  • IV: 9-12 mmol K-Phosph in 100 mL NS over 4 hrs
  • IV: 7.5-15 mmol Sodium Phosph
  • PO: Neutraphosph 1 cap in water TID x 3 (may cause diarrhea)

References

  • xxx