Severe Hypophosphatemia After Zoledronate in a Young Adult With Malnutrition and Long-Term Parenteral Nutrition

Clinicians should recognize malnutrition, refeeding physiology, and total parenteral nutrition dependence as important risk factors for bisphosphonate-induced hypophosphatemia. Targeted phosphate monitoring and nutritional optimization should be considered before and after bisphosphonate therapy in nutritionally vulnerable individuals.