Overview
Hypophosphataemia describes a low serum potassium ion concentration.
Causes
- Dietary insufficiency (e.g. anorexia nervosa)
- Malabsorption syndromes (e.g. coeliac disease)
- Liver failure
- Treatment of diabetic ketoacidosis (insulin drives phosphate into cells)
- Refeeding syndrome
- Osteomalacia
- Hyperparathyroidism
- Vitamin D deficiency
Presentation
Patients may be asymptomatic in mild cases (0.6-0.8 mmol/L). Features may be:
- Muscle weakness
- Bone pain
- Rhabdomyolysis
- Focal neurological deficits
- Altered consciousness levels (e.g. confusion, drowsiness)
Management
- Mild hypophosphataemia may resolve without treatment, whereas severe hypophosphataemia may lead to diaphragmatic weakness requiring artificial ventilation
- Treatment may involve phosphate supplementation and managing the underlying cause
Complications
- Seizures
- Delirium
- Coma
- Heart failure
- Rhabdomyolysis
- White cell dysfunction and increased susceptibility to infection
- Osteomalacia
