Abstract
A case of hypophosphatemia caused by antacid complicated with acute respiratory failure due to alveolar hypoventilation is reported. A 75-year-old man was admitted to our hospital because of dyspnea which began several hours before. On admission, cyanosis and hypopnea were noted, however, no abnormalities except hypopnea were found on physical examination. Chest X-ray film was normal and blood gas analysis revealed marked hypoxemia and hypercapnea and acidosis. Endotracheal intubation was performed and mechanical ventilation was started. He had been followed at a practitioner's out patient clinic because of chronic gastritis. Dried aluminum hydroxide gel and magnesium hydroxide were given over a year. Laboratory examination on admission showed hypophosphatemia and hypophosphaturia. Intravenous administration of dibasic potassium phosphate was started and then, serum phosphate became normal on the 2nd day after admission. In accordance with the increase in serum phosphate, hypopnea improved and mechanical ventilation was discontinued on the 2nd day. Hypophosphatemia in the present case was considered to be due to phosphate depletion due to antacid and might be responsible for the development of acute respiratory failure through respiratory muscle weakness.
