title: Prolonged disturbance of consciousness caused by severe hypophosphatemia: a report of two cases.
abstract: We herein describe two patients with a prolonged disturbance of consciousness due to severe hypophosphatemia. Case one presented with pneumococcal infection and acute exacerbation of chronic obstructive pulmonary disease and asthma. Case two presented with diabetic foot infections and diabetic ketoacidosis. Both patients responded to initial therapy for their primary diseases, but consciousness became worse in both cases. Their test results for impaired consciousness revealed severe hypophosphatemia; therefore, phosphate replacement therapy was administered, thus resulting in complete alertness. These cases demonstrate that we should consider the possibility of hypophosphatemia in critically ill patients with an altered consciousness.
authors.affiliation: Department of Diabetes and Endocrinology, Osaka Red Cross Hospital, Japan.
authors.forename: Takaaki
authors.initials: T
authors.lastname: Murakami
authors.forename: Masanori
authors.initials: M
authors.lastname: Yoshida
authors.forename: Tomoko
authors.initials: T
authors.lastname: Funazo
authors.forename: Yuki
authors.initials: Y
authors.lastname: Matsuda
authors.forename: Koji
authors.initials: K
authors.lastname: Matsuo
authors.forename: Takuo
authors.initials: T
authors.lastname: Nambu
authors.forename: Shin
authors.initials: S
authors.lastname: Yonemitsu
authors.forename: Seiji
authors.initials: S
authors.lastname: Muro
authors.forename: Shogo
authors.initials: S
authors.lastname: Oki
mesh_terms: D000368:Aged; D001249:Asthma / Q000150:complications; D003243:Consciousness; D016883:Diabetic Ketoacidosis / Q000150:complications; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D017674:Hypophosphatemia / Q000097:blood / Q000150:complications* / Q000188:drug therapy; D008875:Middle Aged; D018529:Nutritional Support / Q000379:methods*; D010710:Phosphates / Q000097:blood; D016226:Phosphorus, Dietary / Q000008:administration & dosage*; D029424:Pulmonary Disease, Chronic Obstructive / Q000150:complications; D012720:Severity of Illness Index; D014474:Unconsciousness / Q000188:drug therapy / Q000209:etiology* / Q000503:physiopathology
chemical_list: D010710:Phosphates; D016226:Phosphorus, Dietary