Iron polymaltose-induced FGF23 elevation complicated by hypophosphataemic osteomalacia.
Iron-induced renal phosphate wasting, hypophosphataemia and osteomalacia have previously been reported in a small number of Japanese patients receiving parenteral iron sucrose. We report the case history of a European male who, as a result of regular intravenous iron polymaltose, developed prolonged hypophosphataemia complicated by widespread insufficiency fractures. The pathogenesis of this complication remains unknown however our novel finding of a marked elevation in fibroblast growth factor 23 (FGF23), which normalized after ceasing parenteral iron, suggests an important and previously unreported effect of iron on FGF23 homeostasis.
Schouten
Belinda J
BJ
Department of Endocrinology, Christchurch Public Hospital, Christchurch, New Zealand. Belinda.Robb@cdhb.govt.nz
Doogue
Matthew P
MP
Soule
Steven G
SG
Hunt
Penelope J
PJ
D000328:Adult; D005290:Ferric Compounds / Q000009:adverse effects*; D000089703:Fibroblast Growth Factor-23; D005346:Fibroblast Growth Factors / Q000378:metabolism*; D006801:Humans; D017674:Hypophosphatemia / Q000139:chemically induced*; D007262:Infusions, Intravenous; D008297:Male; D010018:Osteomalacia / Q000139:chemically induced*
C000717427:FGF23 protein, human; D005290:Ferric Compounds; D005346:Fibroblast Growth Factors; D000089703:Fibroblast Growth Factor-23; C013276:teferrol