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[Hypoparathyroidism in hypomagnesemia].

M Borkenstein, M A Dambacher

    Monatsschrift Kinderheilkunde : Organ Der Deutschen Gesellschaft Fur Kinderheilkunde
    |July 1, 1983
    PubMed
    Summary
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    Severe diarrhea in an 18-month-old girl caused tetany, unresponsive to calcium. Magnesium sulfate (MgSO4) treatment corrected hypomagnesemia, hypocalcemia, and functional hypoparathyroidism, resolving tetany.

    Area of Science:

    • Pediatric Endocrinology
    • Mineral Metabolism
    • Clinical Biochemistry

    Background:

    • Tetany is a condition characterized by involuntary muscle contractions and spasms.
    • Severe diarrhea can lead to significant electrolyte disturbances, including hypocalcemia and hypomagnesemia.
    • Functional hypoparathyroidism can contribute to hypocalcemia, particularly in cases of magnesium deficiency.

    Observation:

    • An 18-month-old girl presented with tetany secondary to severe diarrhea.
    • Intravenous calcium administration failed to resolve the tetanic spasms.
    • Laboratory findings revealed hypomagnesemia, hypocalcemia, and functional hypoparathyroidism.

    Findings:

    • Administration of magnesium sulfate (MgSO4) normalized serum magnesium levels.

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  • MgSO4 treatment also increased intact parathyroid hormone (iPTH) levels, suggesting a reversal of functional hypoparathyroidism.
  • Following magnesium repletion, serum calcium and phosphorus levels normalized, and tetany subsided.

    • Implications:

    • Magnesium deficiency can cause functional hypoparathyroidism and end-organ resistance to parathyroid hormone, leading to hypocalcemia.
    • Prompt recognition and treatment of hypomagnesemia are crucial in managing tetany, especially in pediatric cases with severe diarrhea.
    • This case highlights the complex interplay between magnesium, calcium, and parathyroid hormone in maintaining metabolic homeostasis.