Severe Hypophosphatemia in a Patient with Acute Pancreatitis

  • Evagelos Rizos Department of Internal Medicine, Medical School, University of Ioannina. Ioannina, Greece
  • George Alexandrides Department of Internal Medicine, Medical School, University of Ioannina. Ioannina, Greece
  • Moses S Elisaf Department of Internal Medicine, Medical School, University of Ioannina. Ioannina, Greece
Keywords: Hypophosphatemia, Pancreatitis, Phosphorus Metabolism Disorders, Water-Electrolyte Imbalance

Abstract

Context We describe a patient with alcohol-induced pancreatitis who developed severe life-threatening hypophosphatemia of multifactorial origin during hospitalization. Case Report Decreased phosphate levels along with urine phosphate wasting were already noticed on the patient's admission due to underlying chronic alcoholism. However, a further deterioration of hypophosphatemia appeared on the second day of hospitalization presumably resulting from an increased transfer of phosphate from extracellular to intracellular fluid. Conclusions Phosphate deficiency is often overlooked in patients with acute pancreatitis. Our case emphasizes that serum phosphate levels should be checked along with serum calcium levels in patients with acute pancreatitis, especially in alcoholic patients.

Image: Theodore Papagianni sculpture at the University of Ioannina, Greece.

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References

Crook M, Swaminathan R. Disorders of plasma phosphate and indications for its measurement. Ann Clin Biochem 1996; 33:376-96.

Weisinger JR, Bellorin-Font E. Magnesium and phosphorus. Lancet 1998; 352:391-6.

Camp MA, Alon M. Severe hypophosphataemia in hospitalized patients. Miner Electrolyte Metab 1990; 16:365-8.

Elisaf MS, Siamopoulos KC. Mechanisms of hypophosphataemia in alcoholic patients. Int J Clin Pract 1997; 51:501-3.

DeMarchi S, Cecchin E, Basile A, Bertotti A, Nardini R, Bartoli E. Renal tubular dysfunction in alcohol abuse-Effects of abstinence. N Engl J Med 1993; 329 1927-34.

Elisaf M, Merkouropoulos M, Tsianos EV, Siamopoulos KC. Pathogenetic mechanisms of hypomagnesemia in alcoholic patients. J Trace Elem Med Biol 1995; 9:210-4.

Elisaf M, Merkouropoulos M, Tsianos EV, Siamopoulos KC. Acid-base and electrolyte abnormalities in alcoholic patients. Miner Electrolyte Metab 1994; 20:274-81.

Ginn HE, Shanbour LL. Phosphaturia in magnesium deficient rats. Am J Physiol 1967; 212:1347-50.

Body JJ, Cryer PE, Offord KP, Heath H. Epinephrine is a hypophosphatemic hormone in man. Physiological effects of circulating epinephrine on plasma calcium, magnesium, phosphorus, parathyroid hormone, and calcitonin. J Clin Invest 1983; 71:572-8.

Thompson JS, Hodges RE. Preventing hypophosphatemia during total parenteral nutrition. JPEN J Parenter Enteral Nutr 1984; 8:137-9.

da Cunha DF, dos Santos VM, Monterio JP, de Carvalho da Cunha SF. Hypophosphatemia in acute-phase response syndrome patients. Preliminary data. Miner Electrolyte Metab 1998; 24:337-40.

Brady M, Christmas S, Sutton R, Neoptolemos J, Slavin J. Cytokines and acute pancreatitis. Bailliére's Clinical Gastroenterology 1999; 13:265-89.

Barak V, Schwartz A, Kalickman I, Nisman B, Gurman G, Shoenfeld Y. Prevalence of hypophosphatemia in sepsis and infection: the role of cytokines. Am J Med 1998; 104:40-7.

Wesson LG. Homeostasis of phosphate revisited. Nephron 1997; 77:249-66.

Theodore Papagianni sculpture at the University of Ioannina, Greece
Published
2016-06-13
How to Cite
RizosE., AlexandridesG., & ElisafM. (2016). Severe Hypophosphatemia in a Patient with Acute Pancreatitis. JOP. Journal of the Pancreas, 1(4), 204-207. https://doi.org/10.6092/1590-8577/377