Severe hyperphosphatemia after oral laxative administration in a 7-year-old patient

Abstract

Sodium phosphate based laxatives are commonly used for constipationand pre-procedural bowel cleansing. Phosphate intoxication related withthese preparations is well recognized. Herein, we present a case of severehyperphosphatemia and seizure in a 7-year-old male patient after administrationof an oral sodium phosphate based laxative. At the time of admission, serumphosphorus level was 25.6 mg/dl. Aggressive fluid therapy was started.Although serum phosphorus level decreased to 20.9 mg/dl eight hours afteradmission, hemodialysis was performed because of the preexisting renaldisease and declined glomerular filtration rate. Serum phosphorus level andblood gas analysis returned to normal after hemodialysis and the patientwas discharged on hospital day two. In conclusion, sodium phosphate basedlaxatives should be used carefully in patients with preexisting renal diseases.Intravenous hydration and correction of hypocalcemia are important componentsof treatment. Hemodialysis is indicated in patients with renal failure.