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  • • Decreased serum phosphorus

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Epidemiology

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  • • Poor dietary intake (especially in alcoholics)

    • Hyperparathyroidism

    • Phosphate-binding antacid administration

    • Refeeding with total parenteral nutrition with insufficient phosphate supplement

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Symptoms and Signs

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  • • Lassitude, weakness and fatigue may develop with levels below 1 mg/dL

    • Severe neuromuscular manifestations can include convulsions and death

    • Impaired cardiac contractility and rhabdomyolysis with ongoing severe hypophosphatemia

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Laboratory Findings

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  • • Decreased serum phosphorus

    • Anemia from RBC hemolysis

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  • • In perioperative or post-trauma setting, almost always associated with poor nutrition

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  • • Serum electrolytes

    • Nutritional assessment

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  • • Phosphate replenishment

    • Nutritional support

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Treatment Monitoring

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  • • Serum electrolytes

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Prognosis

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  • • Excellent

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References

Subramainan R, Khardori R. Severe hypophosphatemia. Pathophysiologic implications, clinical presentations and treatment. Medicine. 2000;79:1.
Kapoor M, Chan GZ. Fluid and electrolyte abnormalities. Critical Care Clin. 2001;17:503.  [PubMed: 11525047]

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