Hypophosphatemia is an increasingly recognized complication of intravenous (IV) iron therapy, particularly with ferric carboxymaltose (FCM). We present a case of recurrent, symptomatic hypophosphatemia requiring hospitalization following IV FCM infusions, highlighting the clinical course, management challenges, and underlying mechanisms. This case highlights the importance of early recognition, risk stratification, and laboratory monitoring in patients receiving IV iron. It also highlights the importance of carefully selecting patients who truly need IV iron per standard guidelines and the appropriate selection of a specific IV iron formulation based on the patient's background characteristics.
Enchill et al. (2026) studied this question.