Severe Hypophosphatemia-Induced Acute Toxic-Metabolic Encephalopathy in Continuous Renal Replacement Therapy

Sun Ae Han; Ha Yeol Park; Hyun Woo Kim; Jong In Choi; Da Yeong Kang; 김현리; 정종훈; 신병철

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저자정보: Sun Ae Han (Department of Internal Medicine Chosun University Medical School Gwangju Korea) Ha Yeol Park (Department of Internal Medicine Chosun University Medical School Gwangju Korea) Hyun Woo Kim (Department of Internal Medicine Chosun University Medical School Gwangju Korea) Jong In Choi (Department of Internal Medicine Chosun University Medical School Gwangju Korea) Da Yeong Kang (Department of Internal Medicine Chosun University Medical School Gwangju Korea) 김현리 (Department of Internal Medicine Chosun University Medical School Gwangju Korea) 정종훈 (Department of Internal Medicine Chosun University Medical School Gwangju Korea) 신병철 (조선대학교)

저널정보: 전해질고혈압연구회 Electrolytes & Blood Pressure Electrolytes & Blood Pressure Vol.17 No.2

발행연도: 2019.1

수록면: 62 - 65 (4page)

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Acute toxic-metabolic encephalopathy (TME) is an acute condition of global cerebral dysfunction in the absence of primary structural brain disease. Severe hypophosphatemia leads to muscle weakness and involves the diaphragm but hypophosphatemia-induced TME is very rare. Herein, we report the case of a 43-year-old woman with encephalopathy with severe hypophosphatemia during continuous renal replacement therapy. She presented with features of oliguric acute kidney injury on diabetic kidney disease due to volume depletion. At admission, her mental status was alert but gradually changed to stupor mentation during continuous renal replacement therapy. Her phosphate level was less than 0.41 mEq/L and Glasgow coma scale decreased from 15 to 5. After phosphate intravenous replacement and administration of phosphate-containing replacement solution, the phosphate level increased to 2.97 mEq/L and mental state returned to alert state. This case demonstrates that the level of phosphorus should be observed during continuous renal replacement therapy.

#Hypophosphatemia #Encephalopathy #Continuous renal replacement therapy

참고문헌 (15)

참고문헌 신청

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Wijdicks E / 1995 / Neurology of Critical Illness / FA Davis Company :104

Bellomo R / 2014 / The relationship between hypophosphataemia and outcomes during low-intensity and high-intensity continuous renal replacement therapy / Crit Care Resusc 16:34~41

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