Fisher M, Simpser E, Schneider M
Division of Adolescent Medicine, North Shore University Hospital, Manhasset, New York 11030, USA.
Int J Eat Disord. 2000 Sep;28(2):181-7. doi: 10.1002/1098-108x(200009)28:2<181::aid-eat7>3.0.co;2-k.
Hypophosphatemia is a well-known complication of the refeeding syndrome in severe cases of anorexia nervosa, described mostly as a result of refeeding with total parenteral nutrition. Few cases have been reported secondary to either nasogastric or oral refeeding.
The authors present three cases in which hypophosphatemia developed secondary to oral refeeding in severe anorexia nervosa.
All 3 patients developed significant hypophosphatemia, to a low of 0.9 mg/dl in two cases and a low of 1. 7 mg/dl in the third. The first patient received close to 3,000 calories per day, along with intravenous fluids, in the hospital; the other 2 patients ate large amounts for several days at home. Caloric restriction and replenishment with phosphorous resulted in a rapid return of phosphorous values to normal levels.
Those who treat severely malnourished patients with eating disorders, whether as inpatients or outpatients, need to be vigilant for the development of the refeeding syndrome, even in patients receiving oral refeeding alone.
低磷血症是神经性厌食症严重病例中再喂养综合征的一种众所周知的并发症，主要描述为全胃肠外营养再喂养的结果。继发于鼻饲或口服再喂养的病例报道较少。
作者报告了3例严重神经性厌食症患者口服再喂养继发低磷血症的病例。
所有3例患者均出现显著低磷血症，2例最低降至0.9mg/dl，第3例最低降至1.7mg/dl。第1例患者在医院每天摄入近3000卡路里热量，并接受静脉输液；另外2例患者在家中几天内大量进食。热量限制和补充磷导致磷值迅速恢复到正常水平。
治疗患有饮食失调的严重营养不良患者的人员，无论是住院患者还是门诊患者，即使是仅接受口服再喂养的患者，也需要警惕再喂养综合征的发生。
