title: Severe hyperphosphatemia after oral laxative administration in a 7-year-old patient.
abstract: Sodium phosphate based laxatives are commonly used for constipation and pre-procedural bowel cleansing. Phosphate intoxication related with these preparations is well recognized. Herein, we present a case of severe hyperphosphatemia and seizure in a 7-year-old male patient after administration of an oral sodium phosphate based laxative. At the time of admission, serum phosphorus level was 25.6 mg/dl. Aggressive fluid therapy was started. Although serum phosphorus level decreased to 20.9 mg/dl eight hours after admission, hemodialysis was performed because of the preexisting renal disease and declined glomerular filtration rate. Serum phosphorus level and blood gas analysis returned to normal after hemodialysis and the patient was discharged on hospital day two. In conclusion, sodium phosphate based laxatives should be used carefully in patients with preexisting renal diseases. Intravenous hydration and correction of hypocalcemia are important components of treatment. Hemodialysis is indicated in patients with renal failure.
authors.affiliation: Divisions of Pediatric Critical Care, Ankara University Faculty of Medicine, Ankara, Turkey.
authors.forename: Çağlar
authors.initials: Ç
authors.lastname: Ödek
authors.affiliation: Divisions of Pediatric Critical Care, Ankara University Faculty of Medicine, Ankara, Turkey.
authors.forename: Tanıl
authors.initials: T
authors.lastname: Kendirli
authors.affiliation: Divisions of Pediatric Critical Care, Ankara University Faculty of Medicine, Ankara, Turkey.
authors.forename: Ayhan
authors.initials: A
authors.lastname: Yaman
authors.affiliation: Divisions of Pediatric Nephrology, Ankara University Faculty of Medicine, Ankara, Turkey.
authors.forename: Eda Didem
authors.initials: ED
authors.lastname: Kurt-Şükür
authors.affiliation: Division of Pediatric Urology, Department of Urology, Ankara University Faculty of Medicine, Ankara, Turkey.
authors.forename: Onur
authors.initials: O
authors.lastname: Telli
authors.affiliation: Division of Pediatric Urology, Department of Urology, Ankara University Faculty of Medicine, Ankara, Turkey.
authors.forename: Berk
authors.initials: B
authors.lastname: Burgu
authors.affiliation: Divisions of Pediatric Nephrology, Ankara University Faculty of Medicine, Ankara, Turkey.
authors.forename: Z Birsin
authors.initials: ZB
authors.lastname: Özçakar
mesh_terms: D000284:Administration, Oral; D002648:Child; D006801:Humans; D054559:Hyperphosphatemia / Q000139:chemically induced* / Q000628:therapy; D054368:Laxatives / Q000009:adverse effects*; D008297:Male; D010710:Phosphates / Q000009:adverse effects*; D010758:Phosphorus / Q000097:blood; D006435:Renal Dialysis / Q000379:methods; D012640:Seizures / Q000139:chemically induced*
chemical_list: D054368:Laxatives; D010710:Phosphates; D010758:Phosphorus; C018279:sodium phosphate
keywords: hyperphosphatemia; hypocalcemia; laxative; metabolic acidosis; sodium phosphate