HYPOPHOSPHATEMIA IN ACUTE-PHASE RESPONSE SYNDROME PATIENTS - PRELIMINARY DATA

Background: Hypophosphatemia is common in acutely ill patients and pos sibly may occur in the acute-phase response syndrome (APR), secondary to hyperglycemia and shifts of extracellular phosphorus into cells. Ai m: To compare the frequency of hypophosphatemia in patients with or wi thout APR. Methods: All plasma phosphorus results (n = 822) correspond ing to a 6-month period were searched using an university hospital mai nframe. Relevant laboratory and clinical details were also registered. All cases of alcohol withdrawal, diabetic ketoacidosis, parenteral nu trition, and chronic respiratory alkalosis and patients receiving anta cids or intravenous dextrose (5%) in water at a rate higher than 50 g glucose/day were excluded. APR was defined on the basis of severe trau ma or infection and at least two of the following: fever, leukopenia ( WBC <5,000/mm(3)), or leukocytosis (WBC >9,000/mm(3)). Hypophosphatemi a was defined as a serum phosphorus concentration <2.0 mg/dl. Results: A total of 227 patients were studied. Thirty-five (15.4%) patients fu lfilled the criteria for APR. Hypophosphatemia was observed in 11.4% o f the APR-positive patients, in contrast to 0.5% in the APR-negative g roup. Hyperglycemia was more common in APR-positive patients (60.0 vs. 36.8%). Conclusion: Our results suggest that hypophosphatemia may be attributed to increased serum glucose levels secondary to tissue injur y and infection in APR-positive patients.