1/2. Spurious hyperphosphatemia in a patient with alteplase-locked central venous catheter.Alteplase has been shown to be effective in preventing central venous access clotting in patients on hemodialysis. Because of a high phosphorus content in its excipient, it can inadvertently contaminate blood samples, leading the physician in care of the patient to erroneously increase dialysis time or change diet in order to control the pseudo-hyperphosphatemia.- - - - - - - - - - ranking = 1keywords = physician (Clic here for more details about this article) |
2/2. Severe hyperphosphatemia and hypocalcemic tetany after oral laxative administration in a 3-month-old infant.A 3-month-old infant presented to the pediatric emergency department with respiratory distress and tetany after ingestion of a phosphate-containing oral laxative. The initial phosphorus level was 38.3 mg/dL. With aggressive fluid resuscitation and intravenous calcium administration, the infant completely recovered. Although the risks of phosphate-containing enemas are well described, life-threatening hyperphosphatemia can also result from administration of phosphate-containing oral laxatives. Aggressive fluid hydration is the mainstay of treatment. Intravenous calcium administration may be necessary to avoid hemodynamic collapse despite the theoretical possibility of metastatic calcifications. physicians should be alerted to the possibility of phosphate toxicity and hypocalcemic tetany in young children when treated with over-the-counter laxatives. caregivers should be advised not to administer over-the-counter laxatives to infants without physician supervision.- - - - - - - - - - ranking = 1keywords = physician (Clic here for more details about this article) |