Refeeding encephalopathy in a patient with severe hypophosphataemia and hyperammonaemia.
The refeeding syndrome is a potentially fatal condition that affects multiple organ systems. It is the consequence of fluid and electrolyte shifts that may occur in a malnourished patient following the introduction of nutrition therapy. The most prominent characteristic is hypophosphataemia. Although hyperammonaemia is usually seen in decompensated liver cirrhosis or acute liver failure, it may occur in other settings. We report a clinical case of prolonged and severe encephalopathy accompanied by hypophosphataemia and hyperammonaemia in a 59-year-old woman with no preexisting liver disease, urea cycle defects or portosystemic shunting. We suggest that these biochemical abnormalities were caused by uncontrolled refeeding and that the clinical picture was consistent with refeeding encephalopathy.
Department of Hepatology and Gastroenterology, Aarhus University Hospital, Aarhus C, Denmark.
S
S
Becker
Department of Hepatology and Gastroenterology, Aarhus University Hospital, Aarhus C, Denmark.
G
G
Dam
Department of Hepatology and Gastroenterology, Aarhus University Hospital, Aarhus C, Denmark.
C L
CL
Hvas
D001921:Brain / Q000473:pathology*; D004750:Enteral Nutrition / Q000009:adverse effects; D005260:Female; D006801:Humans; D022124:Hyperammonemia / Q000473:pathology*; D017674:Hypophosphatemia / Q000473:pathology*; D044342:Malnutrition / Q000178:diet therapy*; D008875:Middle Aged; D055677:Refeeding Syndrome / Q000473:pathology*; D014883:Water-Electrolyte Imbalance