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Treatment of hypomagnesemia
1Department of Endocrinology, Queen Elizabeth Hospital, Edgbaston, Birmingham, United Kingdom.
Summary
This case highlights symptomatic hypomagnesemia caused by proton pump inhibitors (PPIs) in a patient with short bowel syndrome. Treatment involved magnesium and calcium replacement after PPI withdrawal.
Area of Science:
- Nephrology
- Gastroenterology
- Endocrinology
Background:
- Serum magnesium levels are regulated by intestinal absorption and renal excretion.
- Hypomagnesemia (low magnesium) can stem from poor intake, GI/renal losses, or intracellular shifts.
- Proton pump inhibitors (PPIs) are a known cause of drug-induced hypomagnesemia.
Observation:
- A patient with short bowel syndrome presented with symptomatic hypomagnesemia.
- Concurrent proton pump inhibitor (PPI) therapy was identified as a contributing factor.
- Investigations showed reduced 24-hour urinary magnesium excretion and secondary hypocalcemia.
Findings:
- Discontinuation of PPIs was a key step in management.
- Intravenous and oral magnesium and calcium repletion were administered.
- The case illustrates the complex management of hypomagnesemia.
Implications:
- Clinicians should consider PPIs in patients with unexplained hypomagnesemia, especially those with malabsorption syndromes.
- Monitoring magnesium levels is crucial in patients on long-term PPI therapy.
- This case underscores the importance of a comprehensive, evidence-based approach to treating electrolyte disturbances.
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