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Hypophosphataemia: an important cause of collapse
  1. David M Williams1,2,
  2. Natasha Shrikrishnapalasuriyar1,
  3. David E Price1,
  4. Jeffrey W Stephens1,2
  1. 1Department of Diabetes and Endocrinology, Morriston Hospital, Swansea, UK
  2. 2Diabetes Research Unit, College of Medicine, Swansea University, Swansea, UK
  1. Correspondence to Dr David M Williams, david.williams{at}


We present a case of a 44-year-old man, civil servant, who presented to the emergency department (ED) following an episode of collapse. He was usually fit and well and while at work he had developed a headache with pins and needles over his face and subsequently collapsed. On arrival to ED, he had a Glasgow Coma Scale (GCS) of 4/15. There was no history of note apart from being prescribed citalopram for depression. Laboratory investigations revealed severe hypophosphataemia (phosphate 0.19 mmol/L) and no other electrolyte abnormality. He was commenced on intravenous phosphate and his GCS improved to 15 within 4 hours. Further investigations revealed no cause for his severe hypophosphataemia and repeat bloods in clinic follow-up showed a normal phosphate level.

  • metabolic disorders
  • fluid electrolyte and acid-base disturbances

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  • Contributors DW and NS wrote the manuscript. DP and JS critically reviewed and edited the manuscript. All authors approve the final version for publication.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient consent Obtained.

  • Provenance and peer review Not commissioned; externally peer reviewed.