title: Iron polymaltose-induced FGF23 elevation complicated by hypophosphataemic osteomalacia.
abstract: 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.
authors.affiliation: Department of Endocrinology, Christchurch Public Hospital, Christchurch, New Zealand. Belinda.Robb@cdhb.govt.nz
authors.forename: Belinda J
authors.initials: BJ
authors.lastname: Schouten
authors.forename: Matthew P
authors.initials: MP
authors.lastname: Doogue
authors.forename: Steven G
authors.initials: SG
authors.lastname: Soule
authors.forename: Penelope J
authors.initials: PJ
authors.lastname: Hunt
mesh_terms: 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*
chemical_list: C000717427:FGF23 protein, human; D005290:Ferric Compounds; D005346:Fibroblast Growth Factors; D000089703:Fibroblast Growth Factor-23; C013276:teferrol