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2010 | 5 | 1 | 65-68
Tytuł artykułu

Severe hyperphosphatemia and symptomatic hypocalcemia after bowel cleansing with oral sodium phosphate solution in a patient with postoperative hypoparathyroidism

Treść / Zawartość
Warianty tytułu
Języki publikacji
EN
Abstrakty
EN
Oral sodium phosphate (NaP) is increasingly being used for bowel preparation. There are several reports of significant serum electrolyte changes after the administration of oral NaP solution in renal failure. We report a case of postoperative hypoparathyroidism who developed severe hyperphosphatemia and associated hypocalcemia after bowel preparation with oral NaP. A 39-year old woman was admitted to the hospital because of multiple bone fractures. The diagnosis of primary hyperparathyroidism was confirmed. Further assays suggested Cushing’s disease and MRI disclosed a pituitary microadenoma. Considering the diagnostic suspect of multiple endocrine neoplasia type 1, computed tomography of abdomen was performed, showing a mass in the right adrenal. The patient underwent transsphenoidal surgery and then total parathyroidectomy. Despite total removal of the microadenoma by transsphenoidal surgery, there was no suppression in serum cortisol levels. So, an operation was scheduled for the adrenal tumor. The patient was administered 45 mL oral NaP solution for bowel cleansing before the surgery. Although her calcium and phosphorus levels were normal before NaP administration, four hours later she developed respiratory distress and tetany. Laboratory studies revealed severe hyperphosphatemia and hypocalcemia. We conclude that the use of NaP for bowel preparation should be avoided in patients with hypoparathyroidism.
Wydawca

Czasopismo
Rocznik
Tom
5
Numer
1
Strony
65-68
Opis fizyczny
Daty
wydano
2010-02-01
online
2010-01-29
Twórcy
autor
  • Ankara Numune Research and Training Hospital, Endocrinology and Metabolism Clinic, 06100, Ankara, Turkey, dberker6@yahoo.com
autor
  • Ankara Numune Research and Training Hospital, Endocrinology and Metabolism Clinic, 06100, Ankara, Turkey
autor
  • Ankara Numune Research and Training Hospital, Endocrinology and Metabolism Clinic, 06100, Ankara, Turkey
  • Ankara Numune Research and Training Hospital, Internal Medicine Clinic, 06100, Ankara, Turkey
  • Ankara Numune Research and Training Hospital, Endocrinology and Metabolism Clinic, 06100, Ankara, Turkey
autor
  • Ankara Numune Research and Training Hospital, Internal Medicine Clinic, 06100, Ankara, Turkey
  • Ankara Numune Research and Training Hospital, Endocrinology and Metabolism Clinic, 06100, Ankara, Turkey
autor
  • Ankara Numune Research and Training Hospital, Endocrinology and Metabolism Clinic, 06100, Ankara, Turkey
Bibliografia
  • [1] Malik P., Balaban D.H., Thompson W.O., Galt D.J., Randomized study comparing two regimens of oral sodium phosphates solution versus low-dose polyethylene glycol and bisacodyl, Dig. Dis. Sci., 2009, 54, 833–841 http://dx.doi.org/10.1007/s10620-008-0420-x[Crossref][WoS]
  • [2] Belsey J., Epstein O., Heresbach D., Systematic review: oral bowel preparation for colonoscopy, Aliment. Pharmacol. Ther., 2007, 25, 373–384 http://dx.doi.org/10.1111/j.1365-2036.2006.03212.x[Crossref]
  • [3] Kössi J., Kontula I., Laato M., Sodium phosphate is superior to polyethylene glicol in bowel cleansing and shortens the time it takes to visualize colon mucosa, Scand. J. Gastroenterol. 2003, 38, 1187–1190 http://dx.doi.org/10.1080/00365520310006180[Crossref]
  • [4] Korzets A., Dicker D., Chaimoff C., Zevin D., Life-threatening hyperphosphatemia and hypocalcemic tetany following the use of fleet enemas, J. Am. Geriatr. Soc., 1992, 40, 620–621 [Crossref]
  • [5] Niemeijer N.D., Rijk M.C., van Guldener C., Symptomatic hypocalcemia after sodium phosphate preparation in an adult with asymptomatic hypoparathyroidism, Eur. J. Gastroenterol. Hepatol., 2008, 20, 356–358 http://dx.doi.org/10.1097/MEG.0b013e3282efa590[WoS][Crossref]
  • [6] Lieberman D.A., Ghormley J., Flora K., Effect of oral sodium phosphate colon preparation on serum electrolytes in patients with normal serum creatinine, Gastrointest. Endosc. 1996, 43, 467–469 http://dx.doi.org/10.1016/S0016-5107(96)70287-0[Crossref]
  • [7] Tan H.L., Liew Q.Y., Loo S., Hawkins R., Severe hyperphosphatemia and associated electrolyte and metabolic derangement following the administration of sodium phosphate for bowel preparation, Anaesthesia, 2002, 57, 478–483 http://dx.doi.org/10.1046/j.0003-2409.2001.02519.x[Crossref]
  • [8] Filho A.J., Lassman M.N., Severe hyperphosphatemia induced by a phosphate-containing oral laxative, Ann. Pharmacother., 1996, 30, 141–143
  • [9] Azzam I., Kovalev Y., Storch S., Elias N., Life threatening hyperphosphatemia after administration of sodium phosphate in preparation for colonoscopy, Postgrad. Med. J., 2004, 946, 487–488 http://dx.doi.org/10.1136/pgmj.2003.017244[Crossref]
  • [10] Ullah N., Yeh R., Ehrinpreis M., Fatal hyperphosphatemia from a phosphosoda bowel preparation, J. Clin. Gastroenterol., 2002, 34, 457–458 http://dx.doi.org/10.1097/00004836-200204000-00017[Crossref]
  • [11] Vukasin P., Weston L.A., Beart R.W., Oral fleet phospho-soda laxative-induced hyperphosphatemia and hypocalcemic tetany in an adult: report of a case, Dis. Colon. Rectum., 1997, 40, 497–499 http://dx.doi.org/10.1007/BF02258399[Crossref]
  • [12] Fine A., Patterson J., Severe hyperphosphatemia following phosphate administration for bowel preparation in patients with renal failure: Two cases and a review of the literature, Am. J. Kidney. Dis., 1997, 29, 103–105 http://dx.doi.org/10.1016/S0272-6386(97)90015-9[Crossref]
  • [13] Dipalma J.A., Buckley S.E., Warner B.A., Culpepper R.M., Biochemical effects of oral sodium phosphate, Dig. Dis. Sci., 1996, 41, 749–753 http://dx.doi.org/10.1007/BF02213131[Crossref]
  • [14] Forster I.C., Hernando N., Biber J., Murer H., Proximal tubular handling of phosphate: a molecular perspective, Kidney. Int., 2006, 70, 1548–1559 http://dx.doi.org/10.1038/sj.ki.5001813[Crossref]
  • [15] Berndt T., Kumar R., Phosphatonins and the regulation of phosphate homeostasi, Annu. Rev. Physiol., 2007, 69, 341–359 http://dx.doi.org/10.1146/annurev.physiol.69.040705.141729[Crossref][WoS]
Typ dokumentu
Bibliografia
Identyfikatory
Identyfikator YADDA
bwmeta1.element.-psjd-doi-10_2478_s11536-009-0097-3
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