[Osteomalacia following intravenous iron suppletion].
Osteomalacie na intraveneuze ijzersuppletie.
Journal
Nederlands tijdschrift voor geneeskunde
ISSN: 1876-8784
Titre abrégé: Ned Tijdschr Geneeskd
Pays: Netherlands
ID NLM: 0400770
Informations de publication
Date de publication:
07 10 2021
07 10 2021
Historique:
entrez:
2
12
2021
pubmed:
3
12
2021
medline:
7
1
2022
Statut:
epublish
Résumé
Ferric carboxymaltose (FCM) is highly effective in supplementing iron-deficiency anemia and frequently used. However, it can severely interfere with the phosphate metabolism. A 63 year old man with iron-deficiency anemia due to hereditary hemorrhagic telangiectasia was treated with intravenous FCM. After initiation of the FCM he developed generalized bone and muscle pain as well as insufficiency fractures. Treatment with colecalciferol was started. However, the bone pain increased and further investigation showed a hypophosphatemicosteomalacia with high urine phosphate loss suggesting renal phosphate wasting. Serum FGF23 level was increased confirming the diagnosis of FGF23 mediated hypophosphatemicosteomalacia induced by intravenous iron suppletion. FCM injections may cause FGF23 mediated hypophosphatemia already 4 weeks after suppletion. Therefore it is recommended that serum phosphate levels should be checked frequently. In patients developing hypophosphatemia, a non-maltose form of iron suppletion must be started as well as active vitamin D.
Sections du résumé
BACKGROUND
Ferric carboxymaltose (FCM) is highly effective in supplementing iron-deficiency anemia and frequently used. However, it can severely interfere with the phosphate metabolism.
CASE DESCRIPTION
A 63 year old man with iron-deficiency anemia due to hereditary hemorrhagic telangiectasia was treated with intravenous FCM. After initiation of the FCM he developed generalized bone and muscle pain as well as insufficiency fractures. Treatment with colecalciferol was started. However, the bone pain increased and further investigation showed a hypophosphatemicosteomalacia with high urine phosphate loss suggesting renal phosphate wasting. Serum FGF23 level was increased confirming the diagnosis of FGF23 mediated hypophosphatemicosteomalacia induced by intravenous iron suppletion.
CONCLUSION
FCM injections may cause FGF23 mediated hypophosphatemia already 4 weeks after suppletion. Therefore it is recommended that serum phosphate levels should be checked frequently. In patients developing hypophosphatemia, a non-maltose form of iron suppletion must be started as well as active vitamin D.
Substances chimiques
Iron
E1UOL152H7
Types de publication
Case Reports
Journal Article
Langues
dut
Sous-ensembles de citation
IM