title: Erythrocyte 2,3-diphosphoglycerate depletion associated with hypophosphatemia detected by routine arterial blood gas analysis.
abstract: OBJECTIVE
  To describe a clinical case where an extremely low erythrocyte 2,3-diphosphoglycerate concentration (2,3-DPG) was discovered by routine blood gas analysis supplemented by computer calculation of derived quantities. The finding of a low 2,3-DPG revealed a severe hypophosphatemia.
  
  
  METHODS
  Open uncontrolled study of a patient case.
  
  
  METHODS
  Intensive care observation during 41 days.
  
  
  METHODS
  A 44 year old woman with an abdominal abscess.
  
  
  METHODS
  Surgical drainage, antibiotics and parenteral nutrition.
  
  
  RESULTS
  daily routine blood gas analyses with computer calculation of the hemoglobin oxygen affinity and estimation of the 2,3-DPG. An abrupt decline of 2,3-DPG was observed late in the course coincident with a pronounced hypophosphatemia. The fall in 2,3-DPG was verified by enzymatic analysis.
  
  
  CONCLUSIONS
  2,3-DPG may be estimated by computer calculation of routine blood gas data. A low 2,3-DPG which may be associated with hypophosphatemia causes an unfavorable increase in hemoglobin oxygen affinity which reduces the oxygen release to the tissues.
authors.affiliation: Department of Anesthesiology, Herlev Hospital, University of Copenhagen, Denmark.
authors.forename: V H
authors.initials: VH
authors.lastname: Larsen
authors.forename: T
authors.initials: T
authors.lastname: Waldau
authors.forename: H
authors.initials: H
authors.lastname: Gravesen
authors.forename: O
authors.initials: O
authors.lastname: Siggaard-Andersen
mesh_terms: D019794:2,3-Diphosphoglycerate; D000328:Adult; D000465:Algorithms; D001784:Blood Gas Analysis; D004163:Diphosphoglyceric Acids / Q000097:blood*; D004912:Erythrocytes / Q000737:chemistry; D005260:Female; D006454:Hemoglobins / Q000032:analysis / Q000737:chemistry; D006801:Humans; D017674:Hypophosphatemia / Q000097:blood* / Q000175:diagnosis*; D010100:Oxygen / Q000032:analysis / Q000097:blood; D010710:Phosphates / Q000097:blood; D012984:Software
chemical_list: D004163:Diphosphoglyceric Acids; D006454:Hemoglobins; D010710:Phosphates; D019794:2,3-Diphosphoglycerate; D010100:Oxygen