A rare case of parental iron-induced persistent hypophosphatemia

Abigayle Sullivan1, Theresa Lanham1, Adam Rubin2

  • 1Department of Internal Medicine, Reading Hospital - Tower Health System, Reading, PA, USA.

Insights

Intravenous iron infusions, like ferric carboxymaltose, can cause low phosphate levels. Monitoring phosphate is crucial, and severe cases require intravenous phosphorus and calcitriol treatment.

Area of Science:

  • Internal Medicine
  • Hematology

Background:

  • Parenteral iron is essential for treating iron deficiency anemia (IDA) and other conditions like chronic kidney disease.
  • Ferric carboxymaltose is a widely used intravenous iron formulation known for its efficacy and safety profile.
  • A known side effect of ferric carboxymaltose is a transient decrease in serum phosphate levels.

Observation:

  • A patient presented with fatigue, generalized weakness, and hypophosphatemia after receiving ferric carboxymaltose infusions for severe IDA.
  • The patient's symptoms were attributed to severe hypophosphatemia, a potential complication of the iron infusion therapy.

Findings:

  • This case underscores the importance of monitoring serum phosphate levels in patients receiving parenteral iron, particularly ferric carboxymaltose.
  • Severe hypophosphatemia necessitates prompt management.

Implications:

  • Monitoring serum phosphate is critical for patient safety during and after parenteral iron administration.
  • Intravenous phosphorus and calcitriol are effective treatments for severe hypophosphatemia induced by iron infusions.

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