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[Severe hypophosphatemia--an overlooked condition?].

J W Haukeland1, T Bøhmer

  • 1Medisinsk klinikk, Aker sykehus, Oslo.

Tidsskrift for Den Norske Laegeforening : Tidsskrift for Praktisk Medicin, Ny Raekke
|March 19, 1999
PubMed
Summary

Severe hypophosphataemia, a serious metabolic disturbance, is often overlooked. Prompt phosphate repletion in an alcoholic patient dramatically improved his severe weakness and somnolence.

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Area of Science:

  • Internal Medicine
  • Biochemistry

Background:

  • Severe hypophosphataemia is a critical metabolic disturbance that may be underdiagnosed.
  • Clinicians may not always recognize the signs and symptoms of hypophosphataemia.

Observation:

  • A patient with alcoholism presented with epigastric pain, nausea, and poor health.
  • He developed profound weakness, somnolence, and urinary retention due to bladder paresis.
  • Extremely low serum phosphate levels (0.12 mmol/l) were detected on day seven of hospitalization.

Findings:

  • Intravenous phosphate substitution (60 mmol) over two days led to a dramatic improvement in the patient's clinical condition.
  • Severe hypophosphataemia was identified as a significant contributor to the patient's prolonged critical state.
  • Serum phosphate levels may not accurately reflect total body phosphate stores.

Implications:

  • This case highlights the importance of considering hypophosphataemia in patients with unexplained critical illness.
  • Understanding the diverse manifestations and causes of hypophosphataemia is crucial for timely diagnosis and treatment.
  • Effective phosphate repletion can rapidly reverse severe clinical manifestations of hypophosphataemia.

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