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Symptomatic hypomagnesemia in children

Y K Tsau1, W Y Tsai, F L Lu

  • 1Department of Pediatrics, National Taiwan University Hospital, Taipei, Taiwan.

Zhonghua Minguo Xiao Er Ke Yi Xue Hui Za Zhi [Journal]. Zhonghua Minguo Xiao Er Ke Yi Xue Hui
|February 2, 1999
PubMed
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Symptomatic hypomagnesemia in children is often caused by medications affecting the kidneys. Most cases resolve with magnesium treatment, though some require long-term therapy.

Area of Science:

  • Pediatric Nephrology
  • Clinical Endocrinology
  • Biochemistry

Background:

  • Symptomatic hypomagnesemia presents with electrolyte imbalances like hypocalcemia and hyperphosphatemia, impacting parathyroid function.
  • Common symptoms include seizures, tetany, and weakness, significantly affecting pediatric patients.
  • Medication-induced renal magnesium wasting is a frequent cause, particularly in older children using specific drugs.

Purpose of the Study:

  • To analyze the symptomatology, underlying causes, and treatment outcomes of symptomatic hypomagnesemia in children.
  • To investigate the role of parathyroid hormone (PTH) in hypomagnesemic hypocalcemia.
  • To determine the duration of treatment required for different causes of hypomagnesemia.

Main Methods:

  • Retrospective analysis of 24 children diagnosed with symptomatic hypomagnesemia between January 1996 and June 1998.

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  • Assessment of electrolyte profiles, including calcium, phosphate, and potassium levels.
  • Measurement of parathyroid hormone (PTH) levels in a subset of patients to elucidate the mechanism of hypocalcemia.

    • Main Results:

    • Drug-induced renal magnesium wasting was the predominant cause, linked to aminoglycosides, furosemide, and amphotericin-B.
    • Hypocalcemia and hyperphosphatemia were common, with PTH level analyses indicating impaired PTH synthesis/secretion in most cases.
    • The majority of symptomatic hypomagnesemia cases were transient and resolved with magnesium supplementation.

    Conclusions:

    • Symptomatic hypomagnesemia in children is frequently transient and manageable with magnesium therapy.
    • Medications are a significant cause of renal magnesium wasting, necessitating careful monitoring in pediatric patients.
    • While most cases resolve, a small subset, including those with congenital or primary hypomagnesemia, require long-term magnesium treatment.