Long-Term Follow-up of Hypophosphatemic Bone Disease Associated With Elemental Formula Use: Sustained Correction of Bone Disease After Formula Change or Phosphate Supplementation

Abigail S. Eswarakumar, Nina S. Ma, Leanne M. Ward, Philippe Backeljauw, Halley Wasserman, David R. Weber, Linda A. DiMeglio, Erik A. Imel, Julie Gagne, Declan Cody, Paul Zimakas, Lisa Swartz Topor, Sungeeta Agrawal, Andrew Calabria, Peter Tebben, Ruth S. Faircloth, Rebecca Gordon, Linda Casey, Thomas O. Carpenter

Research output: Contribution to journalArticle

Abstract

In this article, we describe the long-term outcomes of children who were previously reported to have developed hypophosphatemic bone disease in association with elemental formula use. An extended chart review allowed for an updated report of 34 children with regard to severity/duration of bone disease, extent of recovery, and time to correction using radiology reports and biochemical data. After implementation of formula change and/or phosphate supplementation, we found that serum phosphorus concentration increased and serum alkaline phosphatase activity decreased in all patients, normalizing by 6.6 ± 4.0 (mean ± SD) months following diagnosis. The decrease in serum alkaline phosphatase from diagnosis to the time of correction was moderately correlated with the concurrent increase in serum phosphorus (R = 0.48, P <.05). Age at diagnosis significantly correlated with time to resolution (R = 0.51, P =.01). This study supports the earlier report that bone disease associated with hypophosphatemia during elemental formula use responds to formula change and/or phosphate supplementation.

Original languageEnglish (US)
Pages (from-to)1080-1085
Number of pages6
JournalClinical Pediatrics
Volume59
Issue number12
DOIs
StatePublished - Oct 1 2020

Keywords

  • amino acid–based elemental formula
  • hypophosphatemia
  • nutrition
  • phosphate bioavailability
  • rickets

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health

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    Eswarakumar, A. S., Ma, N. S., Ward, L. M., Backeljauw, P., Wasserman, H., Weber, D. R., DiMeglio, L. A., Imel, E. A., Gagne, J., Cody, D., Zimakas, P., Topor, L. S., Agrawal, S., Calabria, A., Tebben, P., Faircloth, R. S., Gordon, R., Casey, L., & Carpenter, T. O. (2020). Long-Term Follow-up of Hypophosphatemic Bone Disease Associated With Elemental Formula Use: Sustained Correction of Bone Disease After Formula Change or Phosphate Supplementation. Clinical Pediatrics, 59(12), 1080-1085. https://doi.org/10.1177/0009922820941097