Proton pump inhibitor-induced hypomagnesemic hypoparathyroidism

Area of Science:

• Pharmacology
• Endocrinology
• Nephrology

Background:

• Proton pump inhibitors (PPIs) are frequently prescribed globally for acid-related gastrointestinal disorders.
• Prolonged oral use of PPIs has been linked to hypomagnesemia and hypoparathyroidism.
• The potential for intravenous PPIs to cause similar electrolyte disturbances is less understood.

Observation:

• This report details the first documented instance of hypomagnesemic hypoparathyroidism potentially associated with intravenous administration of a PPI.
• The patient presented with symptoms indicative of electrolyte imbalance secondary to PPI therapy.

Findings:

• Intravenous PPIs, similar to their oral counterparts, may precipitate severe electrolyte abnormalities, including hypomagnesemia and hypocalcemia.
• This association, though rare, can lead to significant clinical consequences if unrecognized.

Implications:

• Physicians should maintain a high index of suspicion for PPI-induced hypomagnesemia and hypocalcemia, regardless of the route of administration.
• Early recognition and management of these electrolyte disturbances are crucial to prevent potentially life-threatening cardiac and neuromuscular complications.
• This case underscores the importance of monitoring magnesium and calcium levels in patients on long-term PPI therapy, including intravenous formulations.