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Mild Hypophosphatemia-Associated Conditions in Children: The Need for a Comprehensive Approach

Pablo Docio1, Sandra Llorente-Pelayo1, María Teresa García-Unzueta2

  • 1Servicio de Pediatría, Hospital U M Valdecilla, Instituto de Investigación Marqués de Valdecilla (IDIVAL), Universidad de Cantabria, 39011 Santander, Spain.

International Journal of Molecular Sciences
|January 8, 2023
PubMed

Insights

Pediatric hypophosphatemia is often caused by endocrine disorders, tumors, or vitamin D deficiency. This study highlights that it is frequently overlooked, necessitating increased pediatrician awareness and education.

Area of Science:

  • Pediatric Endocrinology
  • Clinical Chemistry
  • Nephrology

Background:

  • Hypophosphatemia, a condition of low serum phosphate, can have significant health implications in children.
  • Identifying the underlying causes of hypophosphatemia is crucial for effective management and preventing complications.

Purpose of the Study:

  • To investigate the common causes of unexpected, persistent, or isolated hypophosphatemia in a pediatric population.
  • To assess the diagnostic evaluation and management of pediatric hypophosphatemia in a real-world clinical setting.

Main Methods:

  • Retrospective analysis of serum phosphate tests from a tertiary hospital over 18 years.
  • Inclusion criteria: unexpected, persistent, or isolated hypophosphatemia.
  • Data collection included patient demographics, diagnoses, and serum phosphate levels.

Main Results:

  • Out of 29,279 tests from 21,398 patients, 268 (1.2%) showed hypophosphatemia.
  • Endocrinopathies (60 patients), tumors (10), and vitamin D deficiency (3) were the most frequent causes.
  • Diabetes mellitus was associated with lower phosphate levels compared to short stature or thyroid disorders.
  • Renal phosphate losses were assessed in less than 5% of cases.

Conclusions:

  • In children, endocrinopathies (especially diabetes), malignancies, and hypovitaminosis D are primary causes of hypophosphatemia.
  • Pediatric hypophosphatemia is often underdiagnosed and inadequately investigated.
  • Increased awareness and education are needed to improve the evaluation and management of this condition in children.

Keywords:
GH deficiencydiabetes mellitushypophosphatemiashort staturethyroid disorders

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