Published online September 25, 2006
PEDIATRICS Vol. 118 No. 5 November 2006, pp. e1580-e1583 (doi:10.1542/peds.2006-1249)
This Article
Right arrow Full Text
Right arrow Full Text (PDF)
Right arrow P3Rs: Submit a response
Right arrow Alert me when this article is cited
Right arrow Alert me when P3Rs are posted
Right arrow Alert me if a correction is posted
Services
Right arrow E-mail this article to a friend
Right arrow Similar articles in this journal
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Add to My File Cabinet
Right arrow Download to citation manager
Right arrow reprints & permissions
Citing Articles
Right arrow Citing Articles via CrossRef
Right arrow Citing Articles via Google Scholar
Google Scholar
Right arrow Articles by Domico, M. B.
Right arrow Articles by Mink, R.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by Domico, M. B.
Right arrow Articles by Mink, R.
Related Collections
Right arrow Therapeutics & Toxicology

EXPERIENCE & REASON

Severe Hyperphosphatemia and Hypocalcemic Tetany After Oral Laxative Administration in a 3-Month-Old Infant

Michele B. Domico, MDa,b, Van Huynh, MDb, Sudhir K. Anand, MDb,c,d and Richard Mink, MDa,b,d

a Divisions of Pediatric Critical Care
c Pediatric Nephrology
b Department of Pediatrics, Harbor-UCLA Medical Center, Los Angeles, California
d Department of Pediatrics, David Geffen School of Medicine at UCLA, Los Angeles, California

ABSTRACT

A 3-month-old infant presented to the pediatric emergency department with respiratory distress and tetany after ingestion of a phosphate-containing oral laxative. The initial phosphorus level was 38.3 mg/dL. With aggressive fluid resuscitation and intravenous calcium administration, the infant completely recovered. Although the risks of phosphate-containing enemas are well described, life-threatening hyperphosphatemia can also result from administration of phosphate-containing oral laxatives. Aggressive fluid hydration is the mainstay of treatment. Intravenous calcium administration may be necessary to avoid hemodynamic collapse despite the theoretical possibility of metastatic calcifications. Physicians should be alerted to the possibility of phosphate toxicity and hypocalcemic tetany in young children when treated with over-the-counter laxatives. Caregivers should be advised not to administer over-the-counter laxatives to infants without physician supervision.

Key Words: hyperphosphatemia • hypocalcemia • laxative • phosphate toxicity • tetany • anion gap

Accepted Jun 7, 2006.