title: Chronic malnutrition may in fact be an acute emergency.
abstract: BACKGROUND
  Reintroduction of nutrition to the chronically starved patient presents a constellation of metabolic challenges termed "refeeding syndrome." The consequences of this syndrome--principally hypophosphatemia--may be life threatening. Although previously described in the nutritional literature, little information exists on this syndrome written from the perspective of the emergency physician.
  
  
  OBJECTIVE
  To promote the early use of prophylactic electrolyte replacement in patients at risk of refeeding syndrome.
  
  
  METHODS
  We present the case of a 32-year-old woman with self-inflicted starvation who developed severe hypophosphatemia, hypocalcemia, and hypomagnesemia due to unintended refeeding in the emergency department (ED).
  
  
  CONCLUSIONS
  The acute complications of refeeding syndrome may present during a patient's stay in the ED or during the transition from the ED to a critical care area, and thus this syndrome deserves consideration from the moment a starved patient presents to our triage desks.
authors: Department of Emergency Medicine, Royal Prince Alfred Hospital, Sydney, Australia.
authors: Sinéad
authors: S
authors: Ní Bhraonáin
authors: Luke Douglas
authors: LD
authors: Lawton
mesh_terms: D000328:Adult; D002908:Chronic Disease; D004636:Emergency Service, Hospital; D005260:Female; D006801:Humans; D053565:Hypercalciuria / Q000209:etiology; D006996:Hypocalcemia / Q000209:etiology; D017674:Hypophosphatemia / Q000209:etiology; D044342:Malnutrition / Q000150:complications*; D009397:Nephrocalcinosis / Q000209:etiology; D055677:Refeeding Syndrome / Q000209:etiology*; D015499:Renal Tubular Transport, Inborn Errors / Q000209:etiology