Hypophosphatemia Differential Diagnoses

Updated: Feb 02, 2022
  • Author: Eleanor Lederer, MD, FASN; Chief Editor: Vecihi Batuman, MD, FASN  more...
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Diagnostic Considerations

Because the symptoms of hypophosphatemia are nonspecific weakness, several alternatives are plausible from the history and include the following:

  • Hypokalemia 
  • Hypomagnesemia
  • Hypothyroidism
  • Primary muscle disorders

Once hypophosphatemia has been diagnosed, establishing that the symptoms the patient is having are due to the hypophosphatemia may be challenging, especially if the hypophosphatemia is mild.  Bone pain is a clue that hypophosphatemia may be exerting an important symptomatic effect. The differential diagnosis of hypophosphatemia then becomes a matter of determining whether the patient has any of the following features:

  •  Very poor diet or evidence of malabsorption
  • A history suggestive of a renal phosphate wasting syndrome, either genetic or acquired
  • A clinical scenario consistent with shift of phosphate into cells, such as refeeding


Differential Diagnoses