Document Detail

The acidosis of exogenous phosphate intoxication.
MedLine Citation:
PMID:  9487238     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: Severe hyperphosphatemia resulting from the use of laxatives and enemas with high levels of phosphate has been the subject of many case reports. These have generally focused on the hypernatremia and hypocalcemia that develop and become life-threatening. Less attention has been paid to the metabolic acidosis of phosphate intoxication. METHODS: In-depth analysis of a case of severe hyperphosphatemia and review of the literature for cases with sufficient data to permit correlation between the phosphate concentration, acidosis, and anion gap. RESULTS: Marked metabolic acidosis with a large increase in the anion gap was present in our patient. The correlation between these parameters and the plasma phosphate concentration was highly significant. Despite a paucity of data in most case reports, we did uncover other cases of anion gap-positive metabolic acidosis in patients with hyperphosphatemia. CONCLUSIONS: Among high-risk patients, including the elderly and debilitated, the presence of metabolic acidosis, hypernatremia, an increased anion gap, and low plasma calcium levels or a prolonged QT interval on the electrocardiogram should raise suspicion of phosphate intoxication.
B Kirschbaum
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Publication Detail:
Type:  Case Reports; Journal Article; Review    
Journal Detail:
Title:  Archives of internal medicine     Volume:  158     ISSN:  0003-9926     ISO Abbreviation:  Arch. Intern. Med.     Publication Date:  1998 Feb 
Date Detail:
Created Date:  1998-03-12     Completed Date:  1998-03-12     Revised Date:  2005-11-16    
Medline Journal Info:
Nlm Unique ID:  0372440     Medline TA:  Arch Intern Med     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  405-8     Citation Subset:  AIM; IM    
Department of Medicine, Medical College of Virginia, Richmond, USA.
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MeSH Terms
Acidosis / blood,  chemically induced*
Cathartics / administration & dosage,  adverse effects*
Hypernatremia / chemically induced
Hypocalcemia / chemically induced
Phosphates / administration & dosage,  adverse effects*,  blood
Reg. No./Substance:
0/Cathartics; 0/Phosphates

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