HYPOCALCEMIA AND HYPERPHOSPHATEMIA AFTER PHOSPHATE ENEMA USE IN A CHILD

The authors present a 3-year-old girl in whom severe hyperphosphatemia and hypocalcemia developed after the administration of three adult-si zed hypertonic phosphate enemas. The commonly held notion that these e nemas are not absorbed and therefore are systemically inactive is inco rrect. With early intervention and treatment, the child survived witho ut sequelae despite a serum phosphate level (74.7 mg/dL) that is great er than those previously reported. The treatment of hyperphosphatemia is reviewed as well as underlying pathology such as altered gastrointe stinal motility and renal insufficiency, which may predispose the pati ent to this problem. Physicians should be aware of the possible advers e effects that can be caused by hypertonic phosphate enemas. Copyright (C) 1997 by W.B. Saunders Company.