Etiology

Inadequate Dietary Intake

• Ethanol Abuse (see Ethanol, [[Ethanol]])

Intracellular Shift

• During Diabetic Ketoacidosis (DKA) Therapy (see Diabetic Ketoacidosis and Hyperosmolar Hyperglycemic State, [[Diabetic Ketoacidosis and Hyperosmolar Hyperglycemic State]])

Drug/Toxin

• Denosumab (Xgeva, Prolia) (see Denosumab, [[Denosumab]])
• Sorafenib (Nexavar) (see Sorafenib, [[Sorafenib]])
• White Phosphorus Toxicity (see White Phosphorus, [[White Phosphorus]])
  • Epidemiology: associated with systemic toxicity

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Diagnosis

• xxx

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Clinical Manifestations

General Comments

• Symptoms Usually Occur at Serum Phosphate Levels <1

Cardiovascular Manifestations

• Congestive Heart Failure (CHF)/Cardiogenic Shock (see Congestive Heart Failure, [[Congestive Heart Failure]] and Cardiogenic Shock, [[Cardiogenic Shock]])

Hematologic Manifestations

• Decreased Leukocyte Function
• Hemolysis (see Hemolytic Anemia, [[Hemolytic Anemia]])
• Platelet Dysfunction (see Coagulopathy, [[Coagulopathy]]): likely due to impaired platelet aggregation

Neurologic Manifestations

• Altered Mental Status/Delirium (see Delirium, [[Delirium]])
• Anxiety (see Anxiety, [[Anxiety]])
• Ballismus (see Ballismus, [[Ballismus]])
• Dysphagia (see Dysphagia, [[Dysphagia]])
• Dysarthria (see Dysarthria, [[Dysarthria]])
• Irritability
• Muscle Cramps
• Parasthesias (see Parasthesias, [[Parasthesias]])
• Rhabdomyolysis (see Rhabdomyolysis, [[Rhabdomyolysis]])
• Seizures (see Seizures, [[Seizures]])
• Weakness

Other Manifestations

• Osteomalacia

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Treatment

• IV: 9-12 mmol K-Phosph in 100 mL NS over 4 hrs
• IV: 7.5-15 mmol Sodium Phosph
• PO: Neutraphosph 1 cap in water TID x 3 (may cause diarrhea)

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References

• xxx