title: Hypophosphatemia is a common complication in severely disabled individuals with neurological disorders and is caused by infection, refeeding and Fanconi syndrome.
abstract: OBJECTIVE
  To describe the characteristics of hypophosphatemia in severely disabled individuals with neurological disorders and to identify its causative factors.
  
  
  METHODS
  We retrospectively reviewed clinical data from 82 individuals with motor skills classified as sitting, rollover or bedridden. Age, gender and body mass index were compared in individuals with (n=19) and without (n=63) a history of hypophosphatemia (serum phosphate levels <2.0 mg/dl). The clinical course of each patient with hypophosphatemia was reviewed and the cause identified. Laboratory data during hypophosphatemia was compared with that after recovery.
  
  
  RESULTS
  The age, gender and body mass index did not differ significantly between the individuals with and without hypophosphatemia. Nineteen patients experienced 25 episodes of hypophosphatemia. The causes included febrile illnesses (n=17), refeeding syndrome (n=4) and Fanconi syndrome (n=3), but was unidentifiable in one episode. Significant elevations in C-reactive protein levels and reductions in sodium levels were observed during hypophosphatemia episodes.
  
  
  CONCLUSIONS
  Hypophosphatemia is a common complication in severely disabled individuals with frequent bacterial infections, refeeding following malnutrition and valproate administration for epilepsy treatment. Because severe hypophosphatemia is life threatening, serum phosphate levels should be closely monitored in this population.
authors.affiliation: Department of Child Neurology, National Center of Neurology and Psychiatry (NCNP), Tokyo, Japan. Electronic address: saitoyo@ncnp.go.jp.
authors.forename: Yoshiaki
authors.initials: Y
authors.lastname: Saito
authors.affiliation: Department of Child Neurology, National Center of Neurology and Psychiatry (NCNP), Tokyo, Japan.
authors.forename: Yusuke
authors.initials: Y
authors.lastname: Aoki
authors.affiliation: Department of Child Neurology, National Center of Neurology and Psychiatry (NCNP), Tokyo, Japan.
authors.forename: Eri
authors.initials: E
authors.lastname: Takeshita
authors.affiliation: Department of Child Neurology, National Center of Neurology and Psychiatry (NCNP), Tokyo, Japan.
authors.forename: Takashi
authors.initials: T
authors.lastname: Saito
authors.affiliation: Department of Child Neurology, National Center of Neurology and Psychiatry (NCNP), Tokyo, Japan.
authors.forename: Kenji
authors.initials: K
authors.lastname: Sugai
authors.affiliation: Department of Child Neurology, National Center of Neurology and Psychiatry (NCNP), Tokyo, Japan.
authors.forename: Hirofumi
authors.initials: H
authors.lastname: Komaki
authors.affiliation: Department of Child Neurology, National Center of Neurology and Psychiatry (NCNP), Tokyo, Japan.
authors.forename: Eiji
authors.initials: E
authors.lastname: Nakagawa
authors.affiliation: Department of Child Neurology, National Center of Neurology and Psychiatry (NCNP), Tokyo, Japan.
authors.forename: Akihiko
authors.initials: A
authors.lastname: Ishiyama
authors.affiliation: Department of Nutritional Management, NCNP, Tokyo, Japan.
authors.forename: Satoko
authors.initials: S
authors.lastname: Takanoha
authors.affiliation: Department of Clinical Laboratory Medicine, NCNP, Tokyo, Japan.
authors.forename: Satoru
authors.initials: S
authors.lastname: Wada
authors.affiliation: Department of Child Neurology, National Center of Neurology and Psychiatry (NCNP), Tokyo, Japan.
authors.forename: Masayuki
authors.initials: M
authors.lastname: Sasaki
mesh_terms: D000293:Adolescent; D000328:Adult; D002097:C-Reactive Protein / Q000378:metabolism; D002648:Child; D002675:Child, Preschool; D002658:Developmental Disabilities / Q000209:etiology*; D005198:Fanconi Syndrome / Q000150:complications*; D005260:Female; D006801:Humans; D017674:Hypophosphatemia / Q000150:complications* / Q000209:etiology*; D007239:Infections / Q000150:complications*; D008297:Male; D008875:Middle Aged; D009422:Nervous System Diseases / Q000209:etiology*; D055677:Refeeding Syndrome / Q000150:complications*; D012189:Retrospective Studies; D012964:Sodium / Q000097:blood; D055815:Young Adult
chemical_list: D002097:C-Reactive Protein; D012964:Sodium
keywords: Childhood; Fanconi syndrome; Hypophosphatemia; Infection; Neurological disorders; Refeeding syndrome