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Fred J. Palmer, MD
Kaiser Foundation Hospital Fontana, Calif

JAMA. 1979;242(26):2845.

	Since this article does not have an abstract, we have provided the first 150 words of the full text PDF and any section headings.

To the Editor.—

Juan and Elrazak (242:163,1979) tabulated the causes of hypophosphatemia in 100 hospitalized patients. They divided their patients into five groups, based on serum phosphorus values, but then did not correlate the level of phosphorus with the proposed cause of the hypophosphatemia. Knochel¹ describes seven causes of severe (less than 1 mg/dL) hypophosphatemia: (1) alcoholic withdrawal, (2) diabetes mellitus, (3) pharmacologic PO₄ binding, (4) recovery or diuretic phase after severe burns, (5) "hyperalimentation," (6) "nutritional recovery syndrome," and (7) severe respiratory alkalosis.

The various components of the syndrome of hypophosphatemia are only now being elucidated, but it is generally believed that the symptoms and altered physiology do not occur until the serum phosphorus level falls below 1 mg/dL. It would therefore be helpful to know which of the causes were associated with severe hypophosphatemia so that hypophosphatemia could be anticipated, serum phosphorus monitored, and appropriate treatment . . . [Full Text PDF of this Article]

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