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Hypophosphatemic Disorders, Pediatric

Erik A. Imel, MD, MS and Peter Tebben, MD Reviewed 10/2018
 


BASICS

DESCRIPTION

Hypophosphatemia is defined by serum phosphorus values below the age-appropriate normal range. Hypophosphatemia may be acute or chronic. Effects on various body systems depend on the...

DIAGNOSIS

HISTORY

  • Family history of hypophosphatemia or rickets

  • Medications

  • Known disease affecting phosphate metabolism (see “Differential Diagnosis”)

  • Nutritional history

    • Vitamin D intake, phosphate sourc...

TREATMENT

MEDICATION

  • Acute hypophosphatemia

    • Oral phosphate supplementation preferred route

    • IV phosphate may be required for severe hypophosphatemia but should be used with caution (see “Alert”).

      • High dose...

ONGOING CARE

FOLLOW-UP RECOMMENDATIONS

  • For acute hypophosphatemia

    • Telemetry if severe and/or treating intravenously

    • Careful laboratory monitoring until resolution (laboratory measures may be needed multi...

ADDITIONAL READING

  • Carpenter TO, Imel EA, Holm IA, et al. A clinician’s guide to X-linked hypophosphatemia. J Bone Miner Res.  2011;26(7):1381–1388. [View Abstract on OvidInsights]

  • Carpenter TO, W...

CODES

ICD9

  • 275.3 Disorders of phosphorus metabolism

  • 270.0 Disturbances of amino-acid transport

ICD10

  • E83.39 Other disorders of phosphorus metabolism

  • E72.09 Other disorders of amino-acid transport

  • E83.31 Fam...

FAQ

  • Q: What are dietary phosphate sources?

  • A: Phosphate sources are ubiquitous; examples include processed meats, dairy, legumes, nuts, whole grains, citrus, and colas. Phosphates are used as a preserv...

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