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Transient hypophosphataemia associated with acute infectious disease in paediatric patients
Charalampos Antachopoulos1, Alexandra Margeli, Maria Giannaki
1First Department of Paediatrics, Athens University, Athens, Greece.
Insights
Hypophosphataemia is common in children with acute infections, particularly pneumonia. This low phosphate level correlates with high C-reactive protein (CRP) and is temporary, resolving before CRP normalizes.
Area of Science:
- Pediatrics
- Infectious Diseases
- Clinical Chemistry
Background:
- Hypophosphataemia, a low serum phosphate level, can occur during acute illness.
- The relationship between hypophosphataemia and inflammatory markers like C-reactive protein (CRP) in pediatric infections requires further investigation.
Purpose of the Study:
- To determine the prevalence of hypophosphataemia in children with various acute infections.
- To examine the correlation between serum phosphate levels and CRP concentration in these patients.
Main Methods:
- Serum phosphate and CRP levels were measured in 238 children (1 month to 14 years) admitted with pneumonia, upper respiratory tract bacterial infection, urinary tract infection, or viral infection.
- Patients were categorized by CRP levels and infection type to calculate hypophosphataemia prevalence.
- Serial measurements were performed on 30 children with hypophosphataemia.
Main Results:
- A significant negative correlation was observed between serum phosphate and CRP levels (r = -0.41, p < 0.0001).
- Children with higher CRP levels (> or = 151 mg/l) exhibited lower mean serum phosphate (1.17 mmol/l) compared to those with lower CRP (< or = 50 mg/l; 1.50 mmol/l).
- Hypophosphataemia prevalence varied by infection type: pneumonia (45%), upper respiratory tract bacterial infection (35.7%), urinary tract infection (18%), and viral infection (4.4%).
Conclusions:
- Hypophosphataemia is a frequent, transient finding in children with acute infectious diseases.
- The condition is linked to elevated CRP levels and typically resolves before CRP returns to normal.
Abstract:
The aim of this study was to investigate the prevalence of hypophosphataemia in children with acute infection and the relationship between serum phosphate and C-reactive protein (CRP) concentration. Serum phosphate and CRP levels were measured on admission in 238 patients (aged 1 month to 14 y) with: pneumonia (n = 51), upper respiratory tract-related bacterial infection (n = 70), urinary tract infection (n = 50) and viral infection (n = 67). Patients were classified according to CRP value (0-50, 51-100, 101-150, > or = 151 mg/l) and type of infection. The prevalence of hypophosphataemia was calculated for each group. 30 children with hypophosphataemia on admission had serial measurements of serum phosphate and CRP levels. A significant negative correlation between serum phosphate and CRP levels was found (r = -0.41, p < 0.0001). Patients with CRP > or = 151 mg/l on admission had a lower mean serum phosphate value than those with CRP < or = 50 mg/l (1.17 vs 1.50 mmol/l, p < 0.0001). The overall prevalence of hypophosphataemia for patients with pneumonia, upper respiratory tract bacterial infection, urinary tract and viral infections was 45%, 35.7%, 18% and 4.4%, respectively. Hypophosphataemia occurred during the phase of rising of CRP level and resolved soon after CRP reached a plateau. In conclusion, hypophosphataemia is a relatively frequent but transient phenomenon in children with acute infectious disease. It is associated with an increase in CRP concentration and resolves before the normalization of CRP levels.