Hypophosphatemia related to intravenous iron therapy with ferric carboxymaltose: A case series

This case series would like to highlight hypophosphatemia related to ferric carboxymaltose and its adverse clinical consequences.Intravenous iron supplementation is a good alternative to oral iron replacement in iron deficiency anaemia due to its ability to correct iron deficit with minimal infusions without incurring the gastrointestinal side effects of oral iron replacement. Ferric carboxymaltose is one common formula for intravenous iron supplementation. However, an increasingly recognised adverse side-effect of intravenous ferric carboxymaltose is hypophosphatemia. There has been increasing reports and studies highlighting hypophosphatemia related to intra-venous iron therapy. Though initially thought to be transient and asymptomatic, recent studies have shown that persistent hypophosphatemia in iron therapy can result in debilitating disease including myopathy, fractures and osteomalacia.A retrospective analysis of all patients who had ferric carboxymaltose was performed.We highlight 3 cases where hyposphatemia affected the clinical outcomes.With the increased use of IV iron it is important to be aware of the high potential for hypophosphatemia secondary to ferric carboxymaltose.