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Hypophosphatemia

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https://www.readbyqxmd.com/read/28203182/treatable-leukoencephalopathy-in-a-patient-with-hypophosphatemia
#1
Masahiro Okazaki, Makito Hirano, Tomoki Iwatsu, Masaki Yamana, Hidekazu Suzuki, Takao Satou, Susumu Kusunoki
We report the first patient with pathologically proven leukoencephalopathy associated with hypophosphatemia. A 61-year-old woman had repetitive episodes of decreased consciousness with pontine and pallidal lesions and extensive leukoencephalopathy on MRI, later found to be associated with hypophosphatemia. Although hypophosphatemia has been linked to central pontine and extrapontine myelinolysis (osmotic myelinolysis), lesions in the deep white matter have not been reported. Brain biopsy performed during the first diagnosis process revealed nonspecific demyelination with gliosis, a finding similar to that of chronic osmotic myelinolysis...
September 2016: Case Reports in Neurology
https://www.readbyqxmd.com/read/28197045/experiences-with-continuous-venovenous-hemofiltration-using-18mmol-l-predilution-citrate-anticoagulation-and-a-phosphate-containing-replacement-solution
#2
Yuen Henry Jeffrey, Shum Hoi-Ping, Anne Leung Kit Hung, Lam Chung-Ling, Yan Wing-Wa, Lai King-Yiu
CONTEXT: Regional citrate anticoagulation for continuous renal replacement therapy is associated with a longer filter-life, less bleeding events and improved mortality. Problems associated with using Prismocitrate 10/2 solution in continuous renal replacement therapy, include hypomagnesemia, hypophosphatemia and the need for additional bicarbonate infusion. AIMS: This study uses the new Prismocitrate 18/0 solution for improved buffer balance and Phoxilium solution for a more favourable electrolyte profile...
January 2017: Indian Journal of Critical Care Medicine
https://www.readbyqxmd.com/read/28193220/a-rare-case-of-multiple-phosphaturic-mesenchymal-tumors-along-a-tendon-sheath-inducing-osteomalacia
#3
Ryuta Arai, Tomohiro Onodera, Mohamad Alaa Terkawi, Tomoko Mitsuhashi, Eiji Kondo, Norimasa Iwasaki
BACKGROUND: Tumor-induced osteomalacia (TIO) is a rare paraneoplastic syndrome characterized by renal phosphate wasting, hypophosphatemia, reduction of 1,25-dihydroxyl vitamin D, and bone calcification disorders. Tumors associated with TIO are typically phosphaturic mesenchymal tumors that are bone and soft tissue origin and often present as a solitary tumor. The high production of fibroblast growth factor 23 (FGF23) by the tumor is believed to be the causative factor responsible for the impaired renal tubular phosphate reabsorption, hypophosphatemia and osteomalacia...
February 13, 2017: BMC Musculoskeletal Disorders
https://www.readbyqxmd.com/read/28190443/neurologic-manifestations-of-major-electrolyte-abnormalities
#4
M Diringer
The brain operates in an extraordinarily intricate environment which demands precise regulation of electrolytes. Tight control over their concentrations and gradients across cellular compartments is essential and when these relationships are disturbed neurologic manifestations may develop. Perturbations of sodium are the electrolyte disturbances that most often lead to neurologic manifestations. Alterations in extracellular fluid sodium concentrations produce water shifts that lead to brain swelling or shrinkage...
2017: Handbook of Clinical Neurology
https://www.readbyqxmd.com/read/28182049/tumor-induced-hypophosphatemia
#5
M Mulani, K Somani, S Bichu, V Billa
Significant hypophosphatemia is commonly due to Vitamin D deficiency. Any sporadic onset of hypophosphatemia in adults warrants workup to identify alternate causes. Hypophosphatemia may also be the only manifestation of an occult malignancy. A high index of clinical suspicion can help diagnose such conditions in early stages. Prompt treatment of the cause can correct this biochemical abnormality. We describe a case report of a woman presenting with severe hypophosphatemia and osteomalacia, leading eventually to the diagnosis of a phosphaturic mesenchymal tumor of the temporo-occipital bone...
January 2017: Indian Journal of Nephrology
https://www.readbyqxmd.com/read/28181822/oncogenic-osteomalacia-role-of-ga-68-dotanoc-pet-ct-scan-in-identifying-the-culprit-lesion-and-its-management
#6
Deepa Singh, Mudalsha Ravina, Narvesh Kumar, Veeresh Dube, Utham Kumar K, Manish Dixit, Sanjay Gambhir
OBJECTIVES: The aim of this study was to evaluate role of (68)Ga-DOTANOC PET/CT scan in localization of culprit lesion for biopsy and required intervention (surgical excision/radiofrequency ablation) in patients with long standing oncogenic osteomalacia (OOM)/tumor induced osteomalacia (TIO). METHODS: 17 patients (08 male & 09 female) underwent (68)Ga-DOTANOC PET/CT scan. The patients referred with clinical and biochemical evidence of hypophosphatemia and raised Fibroblast Growth Factor-23 (FGF-23)...
February 9, 2017: British Journal of Radiology
https://www.readbyqxmd.com/read/28167344/unexpected-widespread-hypophosphatemia-and-bone-disease-associated-with-elemental-formula-use-in-infants-and-children
#7
Luisa F Gonzalez Ballesteros, Nina S Ma, Rebecca J Gordon, Leanne Ward, Philippe Backeljauw, Halley Wasserman, David R Weber, Linda A DiMeglio, Julie Gagne, Robert Stein, Declan Cody, Kimber Simmons, Paul Zimakas, Lisa Swartz Topor, Sungeeta Agrawal, Andrew Calabria, Peter Tebben, Ruth Faircloth, Erik A Imel, Linda Casey, Thomas O Carpenter
OBJECTIVE: Hypophosphatemia occurs with inadequate dietary intake, malabsorption, increased renal excretion, or shifts between intracellular and extracellular compartments. We noticed the common finding of amino-acid based elemental formula [EF] use in an unexpected number of cases of idiopathic hypophosphatemia occurring in infants and children evaluated for skeletal disease. We aimed to fully characterize the clinical profiles in these cases. METHODS: A retrospective chart review of children with unexplained hypophosphatemia was performed as cases accumulated from various centres in North America and Ireland...
February 4, 2017: Bone
https://www.readbyqxmd.com/read/28159828/association-of-serum-phosphorus-concentration-with-mortality-and-graft-failure-among-kidney-transplant-recipients
#8
Hee Jung Jeon, Yong Chul Kim, Seokwoo Park, Clara Tammy Kim, Jongwon Ha, Duck Jong Han, Jieun Oh, Chun Soo Lim, In Mok Jung, Curie Ahn, Yon Su Kim, Jung Pyo Lee, Young Hoon Kim
BACKGROUND AND OBJECTIVES: Hyperphosphatemia in kidney transplant recipients has been shown to predict poorer graft and patient survival. However, studies examining hypophosphatemia are scarce. DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS: To evaluate the association of serum phosphorus level with patient and graft survival, we performed a retrospective multicenter cohort study. Between January of 1997 and August of 2012, 2786 kidney transplant recipients (41.7±11...
February 3, 2017: Clinical Journal of the American Society of Nephrology: CJASN
https://www.readbyqxmd.com/read/28141910/the-mechanism-of-valproic-acid-induced-fanconi-syndrome-involves-mitochondrial-dysfunction-and-oxidative-stress-in-rat-kidney
#9
Reza Heidari, Faezeh Jafari, Forouzan Khodaei, Babak Shirazi Yeganeh, Hossein Niknahad
AIM: Drug-induced kidney proximal tubular injury and renal failure (Fanconi syndrome; FS) is a clinical complication. Valproic acid (VPA) is among the FS-inducing drugs. The current investigation was designed to evaluate the role of mitochondrial dysfunction and oxidative stress in VPA-induced renal injury. METHODS: Animals received VPA (250 and 500 mg/kg, i.p., 15 consecutive days). Serum biomarkers of kidney injury and markers of oxidative stress were assessed...
January 31, 2017: Nephrology
https://www.readbyqxmd.com/read/28130634/x-linked-hypophosphatemia-and-growth
#10
REVIEW
R Fuente, H Gil-Peña, D Claramunt-Taberner, O Hernández, A Fernández-Iglesias, L Alonso-Durán, E Rodríguez-Rubio, F Santos
X-Linked hypophosphatemia (XLH) is the most common form of hereditary rickets caused by loss-of function mutations in the PHEX gene. XLH is characterized by hypophosphatemia secondary to renal phosphate wasting, inappropriately low concentrations of 1,25 dihydroxyvitamin D and high circulating levels of fibroblast growth factor 23 (FGF23). Short stature and rachitic osseous lesions are characteristic phenotypic findings of XLH although the severity of these manifestations is highly variable among patients. The degree of growth impairment is not dependent on the magnitude of hypophosphatemia or the extent of legs´ bowing and height is not normalized by chronic administration of phosphate supplements and 1α hydroxyvitamin D derivatives...
January 27, 2017: Reviews in Endocrine & Metabolic Disorders
https://www.readbyqxmd.com/read/28123560/adefovir-dipivoxil-induced-fanconi-syndrome-and-its-predictive-factors-a-study-of-28-cases
#11
Yong Lin, Fan Pan, Yingchao Wang, Ziqian Chen, Chun Lin, Lvfeng Yao, Xin Zhang, Rui Zhou, Chen Pan
The aim of the present study was to identify monitoring and prevention measures as well as predictive factors for early detection of renal toxicity associated with long-term administration of adefovir dipivoxil in order to avoid progression to Fanconi syndrome. Clinical data of 28 patients with Fanconi syndrome caused by long-term administration of adefovir dipivoxil for the treatment of chronic hepatitis B virus (HBV) infection were collected pre-and post-administration for analysis. Patients presented with fatigue, progressive systemic pain in multiple bones and joints, as well as difficulty in walking and pathological fractures in a number of severe cases...
January 2017: Oncology Letters
https://www.readbyqxmd.com/read/28107068/successful-treatment-of-suspected-pulmonary-arterial-hypertension-in-a-mealy-amazon-parrot-amazona-farinose
#12
Sean M Brady, Anne Burgdorf-Moisuk, Sarah Silverman, Raymund F Wack
A 25-year-old, male mealy Amazon parrot (Amazona farinose) with a history of polycythemia, hepatomegaly, and epistaxis was evaluated for progressive lethargy and anorexia. Clinical laboratory testing revealed severe polycythemia (71%), hypophosphatemia (1.6 mg/dL), and mild hypokalemia (2.8 mEq/L). Radiographs showed marked hepatomegaly and loss of air sac space. Despite supportive treatments, the bird's condition deteriorated, and it developed ataxia, was unable to fly, and became oxygen dependent. An echocardiogram, including an air bubble study, revealed a right-to-left atrial shunt and presumed pulmonary arterial hypertension...
December 2016: Journal of Avian Medicine and Surgery
https://www.readbyqxmd.com/read/28081252/corn-soy-blend-fortified-with-phosphorus-to-prevent-refeeding-hypophosphatemia-in-undernourished-piglets
#13
Anne-Louise Hother, Mikkel Lykke, Torben Martinussen, Hanne Damgaard Poulsen, Christian Mølgaard, Per Torp Sangild, André Briend, Christian Fink Hansen, Henrik Friis, Kim F Michaelsen, Thomas Thymann
BACKGROUND: Phosphorus (P) levels in refeeding diets are very important as undernourished children are at risk of hypophosphatemia during refeeding. For this reason, conventional corn-soy-blends (CSB) have been reformulated by the World Food Programme to obtain a mono-calcium-phosphate fortified product (CSB+) and a product further fortified with skim milk powder (CBS++). METHODS: Using a piglet model of undernourished children, we hypothesized that feeding of CSB+, CSB++ or CSB+ with added whey permeate (CSB+/wp) would help to prevent refeeding hypophosphatemia...
2017: PloS One
https://www.readbyqxmd.com/read/28079295/hypophosphatemia-predicts-a-failure-to-recover-from-adefovir-related-renal-injury-after-dose-reduction-in-lamivudine-resistant-hepatitis-b-patients
#14
Tatsuo Yamamoto, Yasuhiko Maruyama, Naro Ohashi, Hideo Yasuda, Masami Shinozaki
AIM: In chronic hepatitis B patients receiving 10 mg adefovir, dose reduction is recommended when renal injury appears. However, recovery is not always achieved and markers that recommend switching to another antiviral agent are unknown. We investigated adefovir-related renal injury, recovery after dose reduction, and their predictors. METHODS: The renal injury in 77 chronic hepatitis B patients receiving 10 mg adefovir and recovery after dose reduction to alternate day administration in those with adefovir-related renal injury were assessed...
January 12, 2017: Hepatology Research: the Official Journal of the Japan Society of Hepatology
https://www.readbyqxmd.com/read/28073913/raf-kinases-are-essential-for-phosphate-induction-of-erk1-2-phosphorylation-in-hypertrophic-chondrocytes-and-normal-endochondral-bone-development
#15
Garyfallia Papaioannou, Elizabeth T Petit, Eva S Liu, Manuela Baccarini, Catrin Pritchard, Marie B Demay
Hypophosphatemia causes rickets by impairing hypertrophic chondrocyte apoptosis. Phosphate induction of Mek1/2;Erk1/2 phosphorylation in hypertrophic chondrocytes is required for phosphate-mediated apoptosis and growth plate maturation. Mek1/2 can be activated by numerous molecules including Raf isoforms. A- and B-Raf ablation in chondrocytes does not alter skeletal development while ablation of C-Raf decreases hypertrophic chondrocyte apoptosis and impairs vascularization of the growth plate. However, ablation of C-Raf does not impair phosphate-induced Erk1/2 phosphorylation in vitro, but leads to rickets by decreasing VEGF protein stability...
January 10, 2017: Journal of Biological Chemistry
https://www.readbyqxmd.com/read/28061764/biological-toxicities-as-surrogate-markers-of-efficacy-in-patients-treated-with-mtor-inhibitors-for-metastatic-renal-cell-carcinoma
#16
M Jebali, R Elaidi, M Brizard, J Fouque, C Takouchop, B Sabatier, S Oudard, J Medioni
BACKGROUND: Metabolic toxicities of mTOR inhibitors (mTORi) are well characterized. The purpose of the study was to investigate the relationship between these metabolic toxicities and mTORi efficacy. METHODS: From 2007 to 2011, metabolic toxicities were retrospectively collected in patients treated with an mTORi (everolimus, temsirolimus) for a metastatic renal cell carcinoma (mRCC) in a single institution. Patients were eligible if they have received an mTORi for at least 28 days...
January 6, 2017: BMC Cancer
https://www.readbyqxmd.com/read/28053702/outcomes-of-an-inpatient-refeeding-protocol-in-youth-with-anorexia-nervosa-rady-children-s-hospital-san-diego-university-of-california-san-diego
#17
Tamara R Maginot, Maya M Kumar, Jacqueline Shiels, Walter Kaye, Kyung E Rhee
BACKGROUND: Current guidelines for nutritional rehabilitation in hospitalized restrictive eating disorder patients recommend a cautious approach to refeeding. Several studies suggest that higher calorie diets may be safe and effective, but have traditionally excluded severely malnourished patients. The goal of this study was to evaluate the safety of a higher calorie nutritional rehabilitation protocol (NRP) in a broad sample of inpatients with restrictive eating disorders, including those who were severely malnourished...
2017: Journal of Eating Disorders
https://www.readbyqxmd.com/read/28025445/hypertension-is-a-characteristic-complication-of-x-linked-hypophosphatemia
#18
Yoshie Nakamura, Masaki Takagi, Ryojun Takeda, Kentaro Miyai, Yukihiro Hasegawa
X-linked hypophosphatemia (XLH) is a group of rare disorders caused by defective proximal tubular reabsorption of phosphate. Mutations in the PHEX gene are responsible for the majority of cases. There are very few reports of long-term complications of XLH other than skeletal and dental diseases. The aim of this study was to identify the phenotypic presentation of XLH during adulthood including complications other than skeletal and dental diseases. The clinical and biochemical phenotype of 22 adult patients with a PHEX gene mutation were examined retrospectively from their medical records...
December 27, 2016: Endocrine Journal
https://www.readbyqxmd.com/read/28018595/outcomes-of-an-inpatient-refeeding-protocol-in-youth-with-anorexia-nervosa-and-atypical-anorexia-nervosa-at-children-s-hospitals-and-clinics-of-minnesota
#19
Kathryn Smith, Julie Lesser, Beth Brandenburg, Andrew Lesser, Jessica Cici, Robert Juenneman, Amy Beadle, Sarah Eckhardt, Elin Lantz, James Lock, Daniel Le Grange
BACKGROUND: Historically, inpatient protocols have adopted relatively conservative approaches to refeeding in Anorexia Nervosa (AN) in order to reduce the risk of refeeding syndrome, a potentially fatal constellation of symptoms. However, increasing evidence suggests that patients with AN can tolerate higher caloric prescriptions during treatment, which may result in prevention of initial weight loss, shorter hospital stays, and less exposure to the effects of severe malnutrition. Therefore the present study sought to examine the effectiveness of a more accelerated refeeding protocol in an inpatient AN and atypical AN sample...
2016: Journal of Eating Disorders
https://www.readbyqxmd.com/read/28005411/a-mutation-in-the-dmp1-gene-alters-phosphate-responsiveness-in-mice
#20
Shoji Ichikawa, Rita Gerard-O'Riley, Dena Acton, Amie K McQueen, Isabel E Strobel, Phillip C Witcher, Jian Q Feng, Michael J Econs
Mutations in the dentin matrix protein 1 (DMP1) gene cause autosomal recessive hypophosphatemic rickets (ARHR). Hypophosphatemia in ARHR results from increased circulating levels of a phosphaturic hormone, fibroblast growth factor 23 (FGF23). Similarly, elevated FGF23, caused by mutations in the PHEX gene, is responsible for the hypophosphatemia in X-linked hypophosphatemic rickets (XLH). Previously, we demonstrated that a Phex mutation in mice creates a lower set point for extracellular phosphate, where an increment in phosphorus further stimulates Fgf23 production to maintain low serum phosphorus levels...
December 22, 2016: Endocrinology
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