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Hypophosphatemia: Complications

Chronic hypophosphatemia is associated with short stature, rickets phenotype (bowing of the legs), and bone pain.

Severe acute hypophosphatemia can manifest with disorientation, seizures, focal neurologic findings, heart failure, and muscle spasm.

Depletion of adenosine triphosphate (ATP) can lead to myocardial dysfunction and respiratory failure due to weakness of the diaphragm. In critical care setting it can lead to difficulty in weaning mechanical ventilatory support.

In musculoskeletal tissue it can lead to muscle weakness, diplopia, and dysphagia. It can lead to instability of muscle membranes and rhabdomyolysis.

In circulatory system it can lead to white blood cell dysfunction and thus immunocompromisation. It can also lead to hemolytic anemia.

References

  1. Brunelli SM, Goldfarb S. Hypophosphatemia: Clinical Consequences and Management. JASN July 2007 vol. 18 no. 7 1999-2003 PubMed Link
  2. Nakao M, Nakao T, Yamazoe S: Adenosine triphosphate and maintenance of shape of the human red cells. Nature 187 : 945 –946, 1960 PubMed Link
  3. Darsee JR, Nutter DO: Reversible severe congestive cardiomyopathy in three cases of hypophosphatemia. Ann Intern Med 89 : 867 –870, 1978 PubMed Link