0

The full content of Annals is available to subscribers

Subscribe/Learn More  >
Case Reports |

Reduced Red Cell Glycolysis, 2,3-Diphosphoglycerate and Adenosine Triphosphate Concentration, and Increased Hemoglobin-Oxygen Affinity Caused by Hypophosphatemia

MARSHALL A. LICHTMAN, M.D., F.A.C.P.; DENIS R. MILLER, M.D.; JULES COHEN, M.D., F.A.C.P.; and CHRISTINE WATERHOUSE, M.D., F.A.C.F.
[+] Article and Author Information

Presented 8 December 1970 at the Annual Meeting of the American Society of Hematology, San Juan, P.R.

Supported by grants HE06241-09, HE5500, AM13947-01, RR44, and General Research Support Grant, U.S. Public Health Service, Washington, D.C.; grant DA49-193-MD-2656, U.S. Army Medical Research and Development Command, Washington, D.C.; and the U.S. Atomic Energy Commission at the University of Rochester Atomic Energy Project, Rochester, N.Y.

Dr. Lichtman is a Scholar of the Leukemia Society of America; Dr. Cohen is a recipient of a Research Career Development Award K3, HE17, 885, U.S. Public Health Service.

This paper has been assigned Publication No. UR-49-1341.

▸Requests for reprints should be addressed to Marshall A. Lichtman, M.D., Department of Medicine, University of Rochester Medical Center, 260 Crittenden Blvd., Rochester, N.Y. 14620


Rochester, New York


Ann Intern Med. 1971;74(4):562-568. doi:10.7326/0003-4819-74-4-562
Text Size: A A A

A marked reduction in red cell glucose utilization, lactate production, and 2,3-diphosphoglycerate and adenosine triphosphate concentration occurred in a patient with intractable diarrhea during a period of hypophosphatemia induced by parenteral nutrition with hypertonic glucose and protein hydrolysate. During the period of hypophosphatemia the patient's hemoglobin had an increased affinity for oxygen. Restoration of plasma phosphate to normal in vivo or in vitro corrected the metabolic abnormalities of the patient's erythrocytes. During normophosphatemia hemoglobin-oxygen affinity was decreased in keeping with the increase in red cell organic phosphates associated with anemia. Therefore, severe hypophosphatemia in man can produce significant limitations on red cell metabolism, resulting in a curtailment of glycolysis, reduction of organic phosphates, and an inefficient relationship between hemoglobin and oxygen. Tissue oxygen delivery could be impaired under such circumstances. Furthermore, adenosine triphosphate levels can reach concentrations that threaten the survival of the red cell. These observations also provide support for the critical role of extracellular inorganic phosphate concentration in the maintenance and modulation of red cell metabolism in vivo.

Figures

Tables

References

Letters

NOTE:
Citing articles are presented as examples only. In non-demo SCM6 implementation, integration with CrossRef’s "Cited By" API will populate this tab (http://www.crossref.org/citedby.html).

Comments

Submit a Comment
Submit a Comment

Summary for Patients

Clinical Slide Sets

Terms of Use

The In the Clinic® slide sets are owned and copyrighted by the American College of Physicians (ACP). All text, graphics, trademarks, and other intellectual property incorporated into the slide sets remain the sole and exclusive property of the ACP. The slide sets may be used only by the person who downloads or purchases them and only for the purpose of presenting them during not-for-profit educational activities. Users may incorporate the entire slide set or selected individual slides into their own teaching presentations but may not alter the content of the slides in any way or remove the ACP copyright notice. Users may make print copies for use as hand-outs for the audience the user is personally addressing but may not otherwise reproduce or distribute the slides by any means or media, including but not limited to sending them as e-mail attachments, posting them on Internet or Intranet sites, publishing them in meeting proceedings, or making them available for sale or distribution in any unauthorized form, without the express written permission of the ACP. Unauthorized use of the In the Clinic slide sets will constitute copyright infringement.

Toolkit

Buy Now

to gain full access to the content and tools.

Want to Subscribe?

Learn more about subscription options

Advertisement
Related Articles
Related Point of Care
Topic Collections
PubMed Articles
Forgot your password?
Enter your username and email address. We'll send you a reminder to the email address on record.
(Required)
(Required)