Iron polymaltose-induced FGF23 elevation complicated by hypophosphataemic osteomalacia

Ann Clin Biochem. 2009 Mar;46(Pt 2):167-9. doi: 10.1258/acb.2008.008151. Epub 2009 Jan 16.


Iron-induced renal phosphate wasting, hypophosphataemia and osteomalacia have previously been reported in a small number of Japanese patients receiving parenteral iron sucrose. We report the case history of a European male who, as a result of regular intravenous iron polymaltose, developed prolonged hypophosphataemia complicated by widespread insufficiency fractures. The pathogenesis of this complication remains unknown however our novel finding of a marked elevation in fibroblast growth factor 23 (FGF23), which normalized after ceasing parenteral iron, suggests an important and previously unreported effect of iron on FGF23 homeostasis.

Publication types

  • Case Reports

MeSH terms

  • Adult
  • Ferric Compounds / adverse effects*
  • Fibroblast Growth Factor-23
  • Fibroblast Growth Factors / metabolism*
  • Humans
  • Hypophosphatemia / chemically induced*
  • Infusions, Intravenous
  • Male
  • Osteomalacia / chemically induced*


  • FGF23 protein, human
  • Ferric Compounds
  • Fibroblast Growth Factors
  • Fibroblast Growth Factor-23
  • teferrol