As we all know, for the management of anemia most commonly iron therapy is prescribed which is often considered as safe and effective solution.
Do you know it triggers a serious metabolic complication?
Recent evidence showed that the certain iv formulations of iron particularly ferric carboxymaltose induce severe hypophosphatemia.
Here I Came with an two case report to proof this,
CASE 1
A 46 years old male patient with the long term ferric carboxymaltose infusions can developed the severe bone pain, multiple insufficiency fractures and by the lab investigations confirmed the low phosphate levels. Then they stop the iron infusion and replaced with the phosphate plus calcitriol. The outcome was the phosphate level was normalized.
CASE 2
A 61 year old male patient with crohn’s disease develop the persistent hypophosphatemia after iron infusions, also he had the mild low phosphate level earlier due to the malabsorption and iron therapy caused significant drop in the phosphate level. By investigation is confirmed that the renal phosphate wasting mediated by the FGF23.Then the iron infusion was stopped and replace with the supplements thus phosphate levels is improved.
Not all iron therapy is harmless-ferric carboxymaltose can silently lead to the severe phosphate loss.
Let us discuss, What is the pathophysiology behind IV iron induced Hypophosphatemia, especially with ferric carboxymaltose?
MBH/PS