Severe hypophosphataemia after intravenous iron administration

Area of Science:

• Endocrinology
• Hematology
• Nutritional Science

Background:

• Iron deficiency is a prevalent condition often managed with parenteral iron.
• Parenteral iron administration, specifically intravenous ferric carboxymaltose, is a common therapeutic approach.
• Concurrent vitamin D deficiency can be present in patients with iron deficiency.

Observation:

• A case study involving an iron-deficient and vitamin D-deficient woman is presented.
• The patient developed severe symptomatic hypophosphatemia after receiving intravenous ferric carboxymaltose.
• This highlights a potential adverse effect of parenteral iron therapy.

Findings:

• Intravenous ferric carboxymaltose administration can precipitate severe hypophosphatemia.
• Hypophosphatemia in this context is often symptomatic, manifesting as musculoskeletal pain or fatigue.
• Vitamin D deficiency may exacerbate or contribute to this complication.

Implications:

• Physicians require increased awareness of hypophosphatemia as a complication of parenteral iron.
• Patients should be educated about this risk and advised to report specific symptoms.
• Screening symptomatic patients and addressing contributing factors like vitamin D deficiency may mitigate this adverse event.