Mild hypophosphatemia-associated conditions in children: the need for a comprehensive approach
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URI: https://hdl.handle.net/10902/28202DOI: 10.3390/ijms24010687
ISSN: 1661-6596
ISSN: 1422-0067
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Docio, Pablo; Llorente-Pelayo, Sandra; García Unzueta, María Teresa; Lavín Gómez, Bernardo Alio; Puente, Nuria; Mateos, Fátima; Riancho Zarrabeitia, Leyre; González-Lamuño Leguina, Domingo; Riancho Moral, José AntonioFecha
2022Derechos
Attribution 4.0 International
© 2022 by the authors
Publicado en
International Journal of Molecular Sciences 2023, 24, 687
Editorial
MDPI
Palabras clave
GH deficiency
Diabetes mellitus
Hypophosphatemia
Short stature
Thyroid disorders
Resumen/Abstract
To better understand the causes of hypophosphatemia in children, we evaluated all serum phosphate tests performed in a tertiary hospital with unexpected but persistent temporary or isolated hypophosphatemia over an 18 year period. We collected 29,279 phosphate tests from 21,398 patients, of which 268 (1.2%) had at least one result showing hypophosphatemia. We found that endocrinopathies (n = 60), tumors (n = 10), and vitamin D deficiency (n = 3) were the medical conditions most commonly associated with mild hypophosphatemia, but in many patients the cause was unclear. Among patients with endocrinopathies, those with diabetes mellitus were found to have lower mean serum phosphate levels (mean 3.4 mg/dL) than those with short stature (3.7 mg/dL) or thyroid disorders (3.7 mg/dL). In addition, we found a correlation between glycemia and phosphatemia in patients with diabetes. However, despite the potential relevance of monitoring phosphate homeostasis and the underlying etiologic mechanisms, renal phosphate losses were estimated in less than 5% of patients with hypophosphatemia. In the pediatric age group, malignancies, hypovitaminosis D, and endocrine disorders, mostly diabetes, were the most common causes of hypophosphatemia. This real-world study also shows that hypophosphatemia is frequently neglected and inadequately evaluated by pediatricians, which emphasizes the need for more education and awareness about this condition to prevent its potentially deleterious consequences.
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