Refeeding encephalopathy in a patient with severe hypophosphataemia and hyperammonaemia

European Journal of Clinical Nutrition
S BeckerC L Hvas

Abstract

The refeeding syndrome is a potentially fatal condition that affects multiple organ systems. It is the consequence of fluid and electrolyte shifts that may occur in a malnourished patient following the introduction of nutrition therapy. The most prominent characteristic is hypophosphataemia. Although hyperammonaemia is usually seen in decompensated liver cirrhosis or acute liver failure, it may occur in other settings. We report a clinical case of prolonged and severe encephalopathy accompanied by hypophosphataemia and hyperammonaemia in a 59-year-old woman with no preexisting liver disease, urea cycle defects or portosystemic shunting. We suggest that these biochemical abnormalities were caused by uncontrolled refeeding and that the clinical picture was consistent with refeeding encephalopathy.

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Citations

Nov 26, 2015·Neuropsychiatrie : Klinik, Diagnostik, Therapie und Rehabilitation : Organ der Gesellschaft Österreichischer Nervenärzte und Psychiater·Michael MayrAndreas Karwautz
Mar 19, 2015·European Journal of Clinical Nutrition·C L HvasG Dam
Mar 12, 2015·European Journal of Clinical Nutrition·I TasciK Saglam
Feb 17, 2017·Case Reports in Neurology·Masahiro OkazakiSusumu Kusunoki
Aug 18, 2017·BMJ Case Reports·Stuart McIntoshSara Sexton
May 5, 2020·Journal of Clinical Monitoring and Computing·Nina SundströmLars-Owe D Koskinen
Nov 20, 2016·British Journal of Clinical Pharmacology·Palle BagerJens F Dahlerup

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