Severe Hypophosphatemia in a Patient with a Relapsing Lymphoma

Hypophosphatemia in cancer patients is commonly ascribed to chemotherapy, renal wasting or malnutrition from anorexia and poor PO intake. We report a case caused by rapid cancer cell proliferation. 61-year-old woman with history of marginal zone lymphoma diagnosed in 2017 who presented with fatigue, poor oral intake and undetectable phosphate levels (Phos) for 5 days. Her outpatient medications included Acyclovir 400 mg by mouth daily, Allopurinol 100 mg PO daily and Enoxaparin 60 mg under the skin every 12 hours. Blood work revealed phosphate levels less than1 mg/dl (normal 2.4-4.5mg/dl). Her intact PTH level was normal. Her phosphate level further dropped tohttps://jdc.jefferson.edu/medposters/1018/thumbnail.jp