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Severe Hypermagnesemia with Normal Renal Function Can Improve with Symptomatic Treatment
Yoshiaki Ishida1, Akihiko Tabuchi1
1Emergency and Critical Care Center, Anjo Kosei Hospital, 28 Higashihirokute, Anjo-cho, Anjo, Aichi 446-8602, Japan.
Case Reports in Emergency Medicine
|August 1, 2020
Summary
Severe hypermagnesemia, a rare condition, can occur in individuals with normal kidney function, particularly those using magnesium oxide (MgO) for constipation. This case shows that prompt symptomatic treatment, including fluids and diuretics, can effectively manage severe hypermagnesemia without dialysis.
Area of Science:
- Nephrology
- Internal Medicine
- Clinical Toxicology
Background:
- Hypermagnesemia is a rare disorder typically associated with renal dysfunction.
- Standard treatment involves fluids, calcium, diuretics, and potentially hemodialysis for severe cases.
- Few reports detail severe hypermagnesemia in patients with normal renal function.
Observation:
- A 56-year-old woman with constipation and MgO use presented with severe hypermagnesemia (serum Mg 13.5 mg/dL).
- She experienced vomiting, abdominal distension, hypotension (77/34 mmHg), and loss of deep tendon reflexes.
- Abdominal CT revealed bowel distension with wall edema.
Findings:
- The patient was diagnosed with severe hypermagnesemia and intestinal obstruction.
- Treatment included intravenous fluids, loop diuretics, and calcium preparation.
- Serum Mg levels declined, leading to improved consciousness and resolution of symptoms.
Implications:
- Severe hypermagnesemia can occur in patients with normal renal function, particularly with MgO use and constipation.
- Symptomatic management, including fluids and diuretics, may be sufficient for severe hypermagnesemia in this population.
- This case highlights the importance of considering non-renal causes of severe hypermagnesemia.
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