Severe hyperphosphatemia and symptomatic hypocalcemia after bowel cleansing with oral sodium phosphate solution in a patient with postoperative hypoparathyroidism

• Authors: Dilek Berker , Serhat Isik , Yusuf Aydin , Nafiye Helvaci , Yasemin Tutuncu , Kaan Helvaci , Tuncay Delibasi , Serdar Guler
• Languages of publication: EN

Abstracts

EN

Oral sodium phosphate (NaP) is increasingly being used for bowel preparation. There are several reports of significant serum electrolyte changes after the administration of oral NaP solution in renal failure. We report a case of postoperative hypoparathyroidism who developed severe hyperphosphatemia and associated hypocalcemia after bowel preparation with oral NaP. A 39-year old woman was admitted to the hospital because of multiple bone fractures. The diagnosis of primary hyperparathyroidism was confirmed. Further assays suggested Cushing’s disease and MRI disclosed a pituitary microadenoma. Considering the diagnostic suspect of multiple endocrine neoplasia type 1, computed tomography of abdomen was performed, showing a mass in the right adrenal. The patient underwent transsphenoidal surgery and then total parathyroidectomy. Despite total removal of the microadenoma by transsphenoidal surgery, there was no suppression in serum cortisol levels. So, an operation was scheduled for the adrenal tumor. The patient was administered 45 mL oral NaP solution for bowel cleansing before the surgery. Although her calcium and phosphorus levels were normal before NaP administration, four hours later she developed respiratory distress and tetany. Laboratory studies revealed severe hyperphosphatemia and hypocalcemia. We conclude that the use of NaP for bowel preparation should be avoided in patients with hypoparathyroidism.

Keywords

EN

Sodium phosphate; Hyperphosphatemia; Hypocalcemia; Bowel preparation; Hypoparathyroidism

• Publisher: De Gruyter Open
• Journal: Open Medicine
• Year: 2010
• Volume: 5
• Issue: 1
• Pages: 65-68

Dates

published

1 - 2 - 2010

online

29 - 1 - 2010

Contributors

author

Dilek Berker

• Ankara Numune Research and Training Hospital, Endocrinology and Metabolism Clinic, 06100, Ankara, Turkey

author

Serhat Isik

• Ankara Numune Research and Training Hospital, Endocrinology and Metabolism Clinic, 06100, Ankara, Turkey

author

Yusuf Aydin

• Ankara Numune Research and Training Hospital, Endocrinology and Metabolism Clinic, 06100, Ankara, Turkey

author

Nafiye Helvaci

• Ankara Numune Research and Training Hospital, Internal Medicine Clinic, 06100, Ankara, Turkey

author

Yasemin Tutuncu

• Ankara Numune Research and Training Hospital, Endocrinology and Metabolism Clinic, 06100, Ankara, Turkey

author

Kaan Helvaci

• Ankara Numune Research and Training Hospital, Internal Medicine Clinic, 06100, Ankara, Turkey

author

Tuncay Delibasi

• Ankara Numune Research and Training Hospital, Endocrinology and Metabolism Clinic, 06100, Ankara, Turkey

author

Serdar Guler

• Ankara Numune Research and Training Hospital, Endocrinology and Metabolism Clinic, 06100, Ankara, Turkey

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Identifiers

DOI

10.2478/s11536-009-0097-3