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Long-Term Follow-up of Hypophosphatemic Bone Disease Associated With Elemental Formula Use: Sustained Correction of

Abigail S Eswarakumar1, Nina S Ma2,3, Leanne M Ward4

  • 1Yale University, New Haven, CT, USA.

Clinical Pediatrics
|July 16, 2020
PubMed

Insights

Children with hypophosphatemic bone disease from elemental formula use recovered after phosphate supplementation or formula change. Recovery was confirmed by normalized phosphorus levels and reduced alkaline phosphatase activity.

Area of Science:

  • Pediatric Endocrinology
  • Nutritional Science
  • Pediatric Gastroenterology

Background:

  • Elemental formulas are essential for managing specific pediatric gastrointestinal disorders.
  • Hypophosphatemic bone disease has been an observed complication in children using elemental formulas.
  • Long-term outcomes of this condition require further investigation.

Purpose of the Study:

  • To assess the long-term outcomes of hypophosphatemic bone disease in children using elemental formulas.
  • To evaluate the effectiveness of interventions like formula change and phosphate supplementation.
  • To identify factors influencing the duration and severity of bone disease recovery.

Main Methods:

  • Retrospective chart review of 34 children diagnosed with hypophosphatemic bone disease.
  • Analysis of radiological reports and biochemical data (serum phosphorus, alkaline phosphatase).
  • Assessment of recovery extent and time to correction after interventions.

Main Results:

  • All patients showed increased serum phosphorus and decreased alkaline phosphatase after intervention, normalizing within 6.6 months.
  • A moderate correlation was observed between the decrease in alkaline phosphatase and increase in serum phosphorus.
  • Age at diagnosis was significantly correlated with the time to resolution of bone disease.

Conclusions:

  • Elemental formula-associated hypophosphatemic bone disease is responsive to phosphate supplementation and/or elemental formula modification.
  • Early diagnosis and intervention are crucial for timely recovery.
  • Further research into optimizing nutritional management for these children is warranted.

Keywords:
amino acid–based elemental formulahypophosphatemianutritionphosphate bioavailabilityrickets

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