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Hypomagnesaemia - One Cause To Remember!

Ana Filipa Viegas1, Andreia Ferreira Moreira Lopes1, Catarina C Almeida1

  • 1Department of Internal Medicine, Centro Hospitalar Tondela-Viseu, Viseu, Portugal.

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Summary
This summary is machine-generated.

Proton pump inhibitors (PPIs) can cause hypomagnesaemia, a common electrolyte disturbance. Discontinuing PPIs may normalize magnesium levels, especially in refractory cases after other causes are excluded.

Keywords:
Hypomagnesaemiaproton pump inhibitors

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Area of Science:

  • Internal Medicine
  • Gastroenterology
  • Clinical Pharmacology

Background:

  • Hypomagnesaemia is a frequent electrolyte disturbance with diverse causes including diarrhoea, malabsorption, and medications.
  • Proton pump inhibitors (PPIs) are increasingly recognized as a potential cause of hypomagnesaemia, particularly with chronic use.
  • Clinical manifestations of hypomagnesaemia can include neuromuscular and cardiovascular symptoms, hypokalaemia, and altered calcium metabolism.

Purpose of the Study:

  • To highlight PPI-induced hypomagnesaemia as a significant clinical concern.
  • To emphasize the importance of considering PPIs in cases of refractory hypomagnesaemia.
  • To suggest a review of formal indications for chronic PPI use.

Main Methods:

  • Case presentation of a 71-year-old female with refractory hypomagnesaemia.
  • Diagnostic workup to exclude other common causes of hypomagnesaemia.
  • Discontinuation of chronic proton pump inhibitor therapy as a therapeutic trial.

Main Results:

  • The patient presented with dehydration, leucocytosis, and electrolyte abnormalities including hypomagnesaemia, hypocalcaemia, and hypokalaemia.
  • Initial treatment for infectious diarrhoea and electrolyte repletion provided temporary improvement.
  • Discontinuation of the proton pump inhibitor led to normalization of magnesium levels, suggesting PPI-induced hypomagnesaemia.

Conclusions:

  • PPI-related hypomagnesaemia is a critical consideration in patients with persistent low magnesium levels.
  • Thorough exclusion of other causes is essential before attributing hypomagnesaemia to PPIs.
  • Re-evaluation of the necessity for long-term PPI therapy is warranted in many patients.