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Iron polymaltose-induced FGF23 elevation complicated by hypophosphataemic osteomalacia
Belinda J Schouten1, Matthew P Doogue, Steven G Soule
1Department of Endocrinology, Christchurch Public Hospital, Christchurch, New Zealand. Belinda.Robb@cdhb.govt.nz
Abstract:
Iron-induced renal phosphate wasting, hypophosphataemia and osteomalacia have previously been reported in a small number of Japanese patients receiving parenteral iron sucrose. We report the case history of a European male who, as a result of regular intravenous iron polymaltose, developed prolonged hypophosphataemia complicated by widespread insufficiency fractures. The pathogenesis of this complication remains unknown however our novel finding of a marked elevation in fibroblast growth factor 23 (FGF23), which normalized after ceasing parenteral iron, suggests an important and previously unreported effect of iron on FGF23 homeostasis.
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