Blood Gas Changes and Hypophosphatemia in Lactate-Induced Panic

To the Editor.—  Gorman and associates found that 15 minutes before a lactate infusion patients with PD had a lower inorganic phosphate (PO₄) level than controls. Moreover, using a cutoff point of 0.73 mmol/L (2.25 mg/dL), post hoc analysis revealed a significantly greater proportion of low baseline PO₄ levels among the lactate panicker patient group than in the nonpanicker group. The authors conclude that (1) low PO₄ level is associated with PD and (2) the level of PO₄ before a lactate infusion may be a predictor of subsequent lactate vulnerability. Rather than to a metabolic disturbance, the authors ascribe this hypophosphatemia to the HV, which occurred both during the lactate-induced panic attack and before the infusion.In a retrospective examination of 32 patients with PD, as determined by DSM III-R,¹ we failed to find any hypophosphatemia. Mean venous PO₄ level was 1.18 mmol/L (3.65 mg/dL) (SD, 0.18