HYPOPHOSPHATEMIA IN MALNOURISHED CHILDREN DURING REFEEDING

Hypophosphatemia in malnourished children during nutritional recovery (refeeding hypophosphatemia) is recognized as a cause of morbidity and mortality in adolescents with anorexia nervosa but has been only rare ly reported to occur in younger children with other diagnoses. Over a 6-year period, we encountered three cases of refeeding hypophosphatemi a in malnourished children admitted to a pediatric rehabilitation hosp ital, Two children had neurologic dysphagia and one had been starved b y an abusive parent. The one patient who was symptomatic had obtundati on, hemolytic anemia, rhabdomyolysis, and hepatocellular injury that b egan during refeeding and resolved with treatment. The signs and sympt oms, pathophysiology, and treatment of refeeding hypophosphatemia are reviewed.