Fluid & Electrolyte Q 27

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Hypophosphatemia may result from which of the following diseases?

  

    A. Liver cirrhosis

    B. Renal failure

    C. Paget’s disease

    D. Alcoholism

    

    

Correct Answer: D. Alcoholism

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Hypophosphatemia may occur secondary to alcoholism. Hypophosphatemia is typically asymptomatic and is present in up to 5% of patients. It is much more prevalent in alcoholism, diabetic ketoacidosis, or sepsis, with a frequency of up to 80%. The morbidity of hypophosphatemia is highly dependent on its etiology and severity.

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Option A: Chronic liver diseases usually progress to cirrhosis. In the developed world, the most common causes of cirrhosis are hepatitis C virus (HCV), alcoholic liver disease, and nonalcoholic steatohepatitis (NASH), while hepatitis B virus (HBV) and HCV are the most common causes in the developing world.

Option B: Renal failure is usually associated with hyperphosphatemia. Renal failure is the most common cause of hyperphosphatemia. A glomerular filtration rate of less than 30 mL/min significantly reduces the filtration of inorganic phosphate, increasing its serum level. Other less common causes include a high intake of phosphorus or increased renal reabsorption.

Option C: Some literary sources suggest that the family of paramyxoviruses solely causes Paget. However, many studies have come to determine that the osteoclast generation of a unique cytokine found exclusively in the bone marrow of patients diagnosed with Paget disease may be the primary insult. This cytokine is known as IL-6.

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