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Topic: Hypophosphatemia

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	Hypophosphatemia Information on Healthline (Site not responding. Last check: 2007-11-06)
		Hypophosphatemia is a group of inherited disorders in which there is abnormally low levels of the substance phosphate in the blood, leading to softening of the bones.
		Hypophosphatemia is a group of inherited disorders in which there is abnormally low phosphate levels in the blood because large amounts of phosphate exit the body through the urine.
		Hypophosphatemia is a group of conditions that can be inherited or passed on in a family.
	www.healthline.com /galecontent/hypophosphatemia (1136 words)

	Serum Inorganic Phosphorus
		A characteristic of severe hypophosphatemia is skeletal muscle damage with an elevation of the serum creatine phosphokinase and aldolase levels, and in some cases rhabdomyolysis.
		The three primary mechanisms leading to hypophosphatemia are: (1) transcellular shift of phosphorus (from extracellular volume to either soft tissues or bones); (2) poor dietary intake, especially when associated with impaired GI absorption or diarrhea; and (3) increased phosphate excretion resulting from renal and nonrenal causes.
		Hypophosphatemia may be seen in 50% of patients hospitalized with chronic alcoholism.
	www.ncbi.nlm.nih.gov /books/bv.fcgi?rid=cm.chapter.5577 (2362 words)

	eMedicine - Hypophosphatemia : Article by Thomas Mailhot, MD (Site not responding. Last check: 2007-11-06)
		Hypophosphatemia is caused by the intracellular shift of phosphate from serum, increased urinary excretion of phosphate, decreased intestinal absorption of phosphate, or decreased dietary intake.
		Hypophosphatemia may be transient, reflecting intracellular shift with minimal clinical consequences.
		This is a rare cause of hypophosphatemia because of the ubiquity of phosphate in foods.
	www.emedicine.com /emerg/topic278.htm (2732 words)

	eMedicine - Hypophosphatemia : Article by Eleanor Lederer, MD
		Hypophosphatemia is most often caused by long-term, relatively low phosphate intake in the setting of a sudden increase in intracellular phosphate requirements such as occurs with refeeding.
		Hypophosphatemia in the ICU setting is associated with respiratory insufficiency due to impaired diaphragmatic contractility and depressed cardiac output due to decreased myocardial contractility that reverse with correction of the electrolyte abnormality.
		Hypophosphatemia has also been reported in up to 35% of adult patients undergoing open heart surgery and is associated with prolonged mechanical ventilation, increased use of cardiovascular drugs, and prolonged hospitalization.
	www.emedicine.com /MED/topic1135.htm (9020 words)

	Management of Phosphate Disorders (Site not responding. Last check: 2007-11-06)
		Hypophosphatemia is commonly of multifactorial pathogenesis and can be classified by serum levels and/or severity of symptoms and duration.
		To avoid hypophosphatemia associated with TPN therapy, serum phosphorous levels should be monitored and supplemental phosphorous should be added to the TPN formulation.
		It is difficult to provide concrete guidelines for the treatment of severe hypophosphatemia because the extent of total body deficits and response to therapy are difficult to predict.
	daccx.bsd.uchicago.edu /drug/bulletins/N0798.html (1598 words)

	Phosphorus Imbalance \| AHealthyMe.com
		Treating the underlying condition may involve surgical removal of the parathyroid gland in the case of hypophosphatemia caused by hyperparathyroidism; initiating hormone therapy in cases of hyperphosphatemia caused by hypoparathyroidism; ceasing intake of drugs or medications that contribute to phosphorus imbalance; or instigating measures to restore proper kidney function.
		Restoring phosphorus equilibrium in cases of mild hypophosphatemia may include drinking a prescribed solution that is rich in phosphorus; however, since this solution can cause diarrhea, many doctors recommend that patients drink 1 qt (0.9 L) of skim milk per day instead, since milk and other diary products are significant sources of phosphate.
		Hypophosphatemia resulting from poor dietary intake can be prevented by eating foods rich in phosphates, and hypophosphatemia caused by overuse of diuretics or antacids can be prevented by strictly following instructions concerning proper dosages, as can hyperphosphatemia due to excessive use of enemas or laxative.
	www.ahealthyme.com /topic/topic100587292 (1031 words)

	eMedicine - Hypophosphatemia : Article by Eleanor Lederer, MD
		The characteristics of this syndrome (ie, hypophosphatemia, renal phosphate wasting, low 1,25-dihydroxyvitamin D levels) and the fact that PHEX was identified as an endopeptidase suggested the possibility that PHEX might be responsible for the catabolism of a non-PTH circulating factor that regulated proximal tubule phosphate transport and vitamin D metabolism.
		Acute mild hypophosphatemia commonly occurs with the treatment of diabetic ketoacidosis because of the sudden large doses of insulin used to treat the uncontrolled diabetes.
		A complication of the hypophosphatemia of parenteral hyperalimentation.
	www.emedicine.com /med/topic1135.htm (9020 words)

	Metabolic Complications (Site not responding. Last check: 2007-11-06)
		Acute hypophosphatemia due to phosphate ion shift can be seen with alkalosis, which stimulates glycolysis, increasing phosphorylation of carbohydrate compounds within cells.
		Hill et al., using radiolabeled phosphorus in an experimental rat model, found that radiophosphorus was rapidly incorporated into the skeletal muscle of previously starved rats during parenteral nutrition and that uptake by the liver and gut was less than that of non-starved animals.
		They concluded that the early hypophosphatemia seen with parenteral nutrition was due to a rapid influx of phosphorus into the body muscle mass at the initiation of anabolism after a period of catabolism.
	surgery.mc.duke.edu /nutrition/secure/metabolic_complications.html (5114 words)

	Endotext.com - Diabetes, Osteoporosis: Epidemiology and Pathogenesis
		The paradoxical occurrence of hypophosphatemia and normal serum calcitriol levels in affected subjects is consistent with aberrant regulation of 25(OH)D-1a-hydroxylase activity, a supposition supported by extensive studies in the hyp-mouse, the murine homologue of the human disease.
		With the recognition that hypophosphatemia is the definitive marker for XLH, Winters et al (49) and Burnett et al (50) discovered that this disease is transmitted as an X-linked dominant disorder.
		Biochemistries include hypophosphatemia secondary to renal phosphate wasting and normal serum levels of calcium and 25(OH)D. Serum 1,25(OH)2D is overtly low in 19/23 patients in whom measurements have been made (Table 1).
	www.endotext.org /parathyroid/parathyroid10/parathyroid10_2.htm (5262 words)

	Hypophosphatemia -- eCureMe.com
		Hypophosphatemia is a technical way of saying that the
		If hypophosphatemia has been present for a long time, it can cause muscle and bone pain, weak bones, and poor appetite.
		In hypophosphatemia, it is important to find out what is causing the problem in the first place.
	www.ecureme.com /emyhealth/data/Hypophosphatemia.asp (761 words)

	Familial Hypophosphatemia
		Familial hypophosphatemia is a rare inherited disorder characterized by impaired transport of phosphate and diminished Vitamin-D metabolism in the kidneys.
		Familial hypophosphatemia is a form of rickets, a childhood bone disease that results in progressive softening and weakening of the bone structure.
		In familial hypophosphatemia, symptoms occur because of abnormal Vitamin D metabolism and impaired phosphate uptake in the kidneys.
	hw.healthdialog.com /kbase/nord/nord417.htm (2110 words)

	THE MERCK MANUAL, Sec. 2, Ch. 12, Water, Electrolyte, Mineral, And Acid-Base Metabolism
		Hypophosphatemia is seen in 2% of hospitalized patients, but is more prevalent in certain populations, eg, alcoholics, in whom it is seen in up to 10% of hospitalized patients.
		Acute hypophosphatemia with plasma phosphorus < 1 mg/dL (< 0.32 mmol/L) is most often caused by transcellular shifts of PO, often superimposed on chronic hypophosphatemia and PO depletion.
		Removal of the cause of hypophosphatemia, such as cessation of PO -binding antacids or diuretics, or the correction of hypomagnesemia is preferable when possible.
	www.merck.com /pubs/mmanual/section2/chapter12/12e.htm (1129 words)

	Hypophosphatemia, Familial - Quest Diagnostics Patient Health Library (Site not responding. Last check: 2007-11-06)
		It is possible that the main title of the report Hypophosphatemia, Familial is not the name you expected.
		Familial hypophosphatemia is a rare inherited disorder characterized by impaired transport of phosphate and altered vitamin-D metabolism in the kidneys.
		Familial hypophosphatemia results in rickets, a childhood bone disease with characteristic growth plate abnormalities and progressive softening of the bone structure.
	www.questdiagnostics.com /kbase/nord/nord417.htm (448 words)

	Phosphorus, Serum
		Antacids, diuretics, and long term steroids are among the common agents bearing a relationship to severe hypophosphatemia.
		Association of hypophosphatemia with impaired glucose metabolism is thought to reflect decreased tissue sensitivity to insulin.
		Severe hypophosphatemia is most common in elderly patients and is often found in postoperative subjects.
	www.labcorp.com /datasets/labcorp/html/chapter/mono/pr007000.htm (825 words)

	Recombinant growth hormone therapy for X-linked hypophosphatemia in children (Cochrane Review) (Site not responding. Last check: 2007-11-06)
		Conventional treatment of X-linked hypophosphatemia with oral phosphate and calcitriol can heal rickets, but it does not always raise serum phosphate concentrations significantly, nor does it always normalize linear growth.
		To determine whether recombinant human growth hormone therapy for children with X-linked hypophosphatemia is associated with changes in longitudinal growth, mineral metabolism, endocrine function, renal function, bone mineral density, body proportions, and also with any adverse effects.
		We have found no conclusive evidence to indicate that the use of recombinant human growth hormone therapy in children with X-linked hypophosphatemia is associated with changes in longitudinal growth, mineral metabolism, endocrine, renal function, bone mineral density, and body proportions.
	www.update-software.com /Abstracts/AB004447.htm (509 words)

	JAMA -- Abstract: The mechanism of hypophosphatemia in acute heat stroke, August 1, 1977, Knochel and Caskey 238 (5): ...
		JAMA -- Abstract: The mechanism of hypophosphatemia in acute heat stroke, August 1, 1977, Knochel and Caskey 238 (5): 425
		The mechanism of hypophosphatemia in acute heat stroke
		The hypophosphatemia abated spontaneously as metabolic acidosis and acute
	jama.ama-assn.org /cgi/content/abstract/238/5/425 (77 words)

	Hypophosphatemia associated with coma -- Lee et al. 119 (2): 143 -- Canadian Medical Association Journal
		Hypophosphatemia associated with coma -- Lee et al.
		In three cases of severe hypophosphatemia profound coma was associated.
		Although the occurrence of hypophosphatemia appeared to coincide with a
	www.cmaj.ca /cgi/content/abstract/119/2/143 (144 words)

	UpToDate Causes of hypophosphatemia
		— The reported prevalence of hypophosphatemia varies widely, depending upon the patient population surveyed and the concentration of serum phosphorus used to define hypophosphatemia.
		Profound hypophosphatemia (less than 1.0 mg/dL [0.32 mmol/L]), which can lead to physiological disturbances and symptoms, is much less common [3-5].
		It is most likely to occur during treatment of patients with diabetic ketoacidosis or nonketotic hyperglycemia (in which the glucose-induced osmotic diuresis results in loss of phosphate in the urine), during carbohydrate refeeding in malnourished patients with alcoholism or anorexia nervosa [6,7], and in patients receiving hyperalimentation.
	patients.uptodate.com /topic.asp?file=minmetab/9695 (414 words)

	What Is Hypophosphatemia and Hyperphosphatemia
		Hypophosphatemia may be described as low levels of inorganic phosphate in the blood.
		There are no symptoms of hypophosphatemia, unless the values are critically low.
		The symptoms that you notice, with lowered phosphate levels, are due to the disease that is causing this abnormality.
	www.chemocare.com /MANAGING/hyperphosphatemia__hypophosphatemia.asp (1365 words)

	Phosphate: Minerals and Electrolytes: Merck Manual Home Edition
		In hypophosphatemia, the level of phosphate in the blood is too low.
		Chronic hypophosphatemia occurs in people who have hyperparathyroidism, hypothyroidism (an underactive thyroid gland), or impaired kidney function or who use diuretics for a long time.
		If hypophosphatemia is very severe or if phosphate cannot be taken by mouth, intravenous phosphate may be given.
	www.merck.com /pubs/mmanual_home2/sec12/ch155/ch155h.htm (472 words)

	p980918b - Hypophosphatemia in Refeeding
		Nutritional support is often delayed in patients in the intensive care unit (ICU) as a consequence of enteral intolerance and bowel hypomotility.
		Refeeding hypophosphatemia was considered to have developed in patients whose serum phosphorus level fell by more than 0.16 mmol/L to below 0.65 mmol/L. RESULTS: Twenty-one patients (34%) experienced refeeding hypophosphatemia.
		The literature addressing RS focuses on only one electrolyte abnormality, hypophosphatemia; however, often all three electrolyte levels are perturbed.
	www.emory.edu /WHSCL/grady/amreport/litsrch98/p980918b.html (344 words)

	Hypophosphatemia - complications
		Hypophosphatemic causes weakness of respiratory muscles, particularly the diaphragm, and causes a leftward shift of the oxyhemoglobin dissociation curve (increasing the tendency for hemoglobin to cling onto oxygen).
		As one would expect, hypophosphatemia causes skeletal muscle weakness, which may mimic a myopathy.
		Hypophosphatemia may cause myocardial dysfunction (Zazzo JF ICM 1995; hypophosphatemia), and may make the myocytes less sensitive to the stimulatory effects of catecholamines.
	www.ccmtutorials.com /misc/phosphate/page_05.htm (204 words)

	Severe Hypophosphatemia in Sepsis as a Mortality Predictor -- Shor et al. 36 (1): 67 -- Annals of Clinical and ...
		Severe Hypophosphatemia in Sepsis as a Mortality Predictor -- Shor et al.
		Severe Hypophosphatemia in Sepsis as a Mortality Predictor
		Hypophosphatemia has long been reported to be associated with
	www.annclinlabsci.org /cgi/content/abstract/36/1/67 (246 words)

	HypoPhosphatemia: diff dx - Wheeless' Textbook of Orthopaedics
		HypoPhosphatemia: diff dx - Wheeless' Textbook of Orthopaedics
		- hypophosphatemia is the most common metabolic anomaly in rickets;
		- to treat hypophosphatemia, 1 to 3 g oral or rectal phosphorus may
	www.wheelessonline.com /ortho/hypophosphatemia_diff_dx (223 words)

	MIR Teaching file case bs041
		X-linked hypophosphatemia (also known as familial vitamin D-resistant rickets) is the most common form of renal tubular rickets and osteomalacia.
		This syndrome, which is characterized by life-long hypophosphatemia secondary to renal tubular phosphate loss, decreased intestinal absorption of calcium, and normal serum levels of calcium, usually appears between 12 and 18 months of age.
		Treatment of hypophosphatemia includes phosphate infusion and large doses of vitamin D. References: Resnik D. Bone and Joint Imaging.
	gamma.wustl.edu /bs041te145.html (511 words)

	The XLH Network inc. - (Site not responding. Last check: 2007-11-06)
		The name typically used by professionals today is X-Linked Hypophosphatemia which is generally referred to by its acronym: XLH.
		The rest of the name, hypophosphatemia, identifies the primary and key sign of XLH, which is a low level of phosphorus in the blood.
		Knock-knees or bowing of the legs are the most noticeable symptoms of the rickets disorder which can occur as a result of hypophosphatemia, although these symptoms may be mild, moderate or severe in different individuals with XLH.
	www.xlhnetwork.org /site/WhatIsXLH.html (441 words)

	CME Online (Site not responding. Last check: 2007-11-06)
		Audience: Internists, family practice physicians, and physicians providing primary care who might encounter patients with hypophosphatemia.
		Purpose: To provide the participant with a basic understanding of the underlying physiologic mechanisms, evaluation, and management of hypophosphatemia.
		Describe the pathophysiology of hypophosphatemia and associated signs and symptoms
	cme-online.med.upenn.edu /index.pl?op=show;isa=Course;iid=21776 (424 words)

	The Effect of Recombinant Human Growth Hormone in Children With X-Linked Hypophosphatemia -- Seikaly et al. 100 (5): ...
		X-linked hypophosphatemia (XLH) is characterized clinically by rickets and growth retardation.
		X-linked hypophosphatemia (XLH) is the most common inherited abnormality of renal phosphate transport.
		We prospectively evaluated the safety and efficacy of rhGH therapy in two male and three female children with familial hypophosphatemia.
	pediatrics.aappublications.org /cgi/content/full/100/5/879 (2697 words)

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