Life-threatening hypophosphatemia in 74-year-old woman with recurrent pneumonia and progressive muscular atrophy]

Although hypophosphatemia can be a serious threat to health and life, it is a problem rarely taken into consideration in the differential diagnosis in the current clinical practice. The aim of the study was to present the description of hypophosphatemia issues in the context of the threat they may pose to the health and life when undiagnosed.74-year-old internal charged woman , with progressive destruction for a few years, recurrent pneumonia, and a compression fracture of the spine, was admitted to hospital because of fainting and general deterioration. In the course of the performed diagnostics primary hyperparathyroidism was diagnosed with pre-existing inadequate severe hypophosphatemia. Because the presented clinical picture, only partially tie in symptomatology of primary hiperparathyroidism, the diagnostic process was targeted to search for other causes of both hypophosphatemia and symptoms reported by the patient. Finally, in addition to PHPT ( primary hyperparathyroidism) also vitamin D deficiency and tuberculosis was found. The fact that the treatment of infectious disease led to the phosphatemia standardization , and thus to significant improvement of the overall demonstrates, shows the significant contribution of tuberculosis in the pathogenesis of phosphate deficiency in this case.Our case is an example of confirming the need for a thorough and multidirectional analysis of the clinical picture, which is a prerequisite for a correct diagnosis.