Gwenette Andera War¹*, Debashis Priyadarshan Sahoo¹ and Siddharth Bhaumik²

¹General Medicine, AIIMS, Guwahati, India
²General Medicine, NEIGRIHMS, Shillong, India

*Corresponding Author: Gwenette Andrea War, Assistant Professor, Department of General Medicine, AIIMS, Guwahati, Changsari, Assam, India.

Received: July 22, 2024; Published: September 06, 2024

Abstract

Introduction: Anemia, affecting 1.62 billion globally, is commonly due to iron deficiency. Treatments include oral supplements, intravenous (IV) infusions, and blood transfusions, with ferric Carboxymaltose (FCM) often preferred for IV infusions due to its ef fectiveness. However, FCM can cause hypophosphatemia by increasing fibroblast growth factor 23 (FGF23), leading to higher renal phosphate excretion and lower serum phosphate levels.

Case Report: A 48-year-old woman with Type 2 diabetes and iron deficiency anemia chose FCM for treatment. Despite an initial improvement in hemoglobin levels, she developed severe hypophosphatemia two weeks post-infusion, presenting with muscle pain and fatigue. Labarotory tests confirmed low phosphate levels. Treatment with oral phosphate and calcitriol improved her symptoms over a month.

Discussion: Iron deficiency anemia treatment varies based on severity and patient needs. FCM offers rapid iron correction with a low risk of anaphylactic reactions but has a significant side effect of hypophosphatemia. This occurs due to increased Fibroblast Growth Factor 23 levels, leading to increased phosphate excretion and reduced calcitriol levels, further decreasing phosphate absorption.

Conclusion: To prevent severe hypophosphatemia in patients receiving FCM, it is crucial to monitor and manage serum phosphate, calcium, and vitamin D levels, especially in at-risk individuals. Proactive supplementation and regular follow-up are essential for early detection and treatment of deficiencies.

Keywords: Ferric Carboxymaltose; Hypophosphatemia; Fibroblast Growth Factor-23; Anemia; Vitamin D

References

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3. Koduru Pramoda and Bincy P Abraham. “The role of ferric carboxymaltose in the treatment of iron deficiency anemia in patients with gastrointestinal disease”. Therapeutic Advances in Gastroenterology1 (2016): 76-85.
4. Schaefer Benedikt., et al. “Risk Factors for and Effects of Persistent and Severe Hypophosphatemia Following Ferric Carboxymaltose”. The Journal of Clinical Endocrinology and Metabolism4 (2022): 1009-1019.
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6. Ifie Eseoghene., et al. “Symptomatic hypophosphataemia after intravenous iron therapy: an underrated adverse reaction”. Endocrinology, Diabetes and Metabolism Case Reports 1(2019): 19-0065.

Citation

Citation: Gwenette Andera War., et al. “Unveiling the Unexpected: Notable Side Effect of IV Ferric Carboxymaltose - A Case Report". Acta Scientific Pharmacology 5.1 (2025): 03-06.

Copyright

Copyright: © 2025 Gwenette Andera War., et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.