Management Goals for Asymptomatic Persistent Hypophosphatemia in Malnourished Patients with Cancer: A Case Report and Clinical Reflections

Journal: Journal of Clinical Medicine Research DOI: 10.32629/jcmr.v7i2.5284

Xiaoxi Wu, Xia Zhang, Yang Ling

Affiliated Hospital of Hebei University, Baoding, Hebei, China

Abstract

This article reports the case of a 68-year-old patient with colon cancer and severe malnutrition who was at high risk of refeeding syndrome and had persistent hypophosphatemia before and after admission, with a nadir serum phosphate level of 0.21 mmol/L. After combined intravenous and oral phosphate supplementation, the serum phosphate level was maintained at 0.4–0.5 mmol/L. The patient had no arrhythmia, decreased muscle strength, bone pain, or neurological abnormalities. This report suggests that the management goal for asymptomatic severe hypophosphatemia in malnourished patients with cancer should not be limited to rapid correction of serum phosphate; rather, attention should be paid to acute safety, tolerance of progressive nutritional advancement, and long-term etiological evaluation.

Keywords

hypophosphatemia; malnutrition; cancer; refeeding syndrome; phosphate supplementation

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