[Asymptomatic hyperphosphatemia in late refeeding of an eating disorder].

Refeeding syndrome is a serious complication following the reintroduction of nutrition in severely malnourished patients. It is accompanied by metabolic disturbances, with hypophosphatemia being an early and common finding. However, the occurrence of hyperphosphatemia in the later stages of refeeding is an unusual and poorly studied finding. Increased tubular reabsorption of phosphate (TRP) seems to be the underlying mechanism. This could be explained by the activation of the GH/IGF-1 system, associated with refeeding, which inhibits FGF-23 secretion and leads to a reduction in TRP. Contradictorily, FGF-23 levels are elevated, suggesting a resistance to its action. This phenomenon appears to be adaptive and is frequently transient and asymptomatic.