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  • • Low serum magnesium

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Epidemiology

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  • • Occurs with poor dietary intake, intestinal malabsorption, or excessive losses from the gut

    • Can also be caused by excessive urine losses, chronic alcohol abuse, hyperaldosteronism, and hypercalcemia

    • Occasionally, develops in acute pancreatitis, diabetic acidosis, burn victims, or with prolonged total parenteral nutrition (TPN) administration

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Symptoms and Signs

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  • • Hyperactive deep tendon reflexes

    • Positive Chvostek sign

    • Tremors

    • Delirium

    • Convulsions

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Laboratory Findings

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  • • Low serum magnesium

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  • • Depends on clinical suspicion and serum levels

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  • • Serum levels of calcium, magnesium, and other electrolytes

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  • • Administering supplemental magnesium

    • PO replacement for minor to moderate hypomagenesemia

    • For severe deficits: IV magnesium sulfate

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Complications

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  • • IV supplementation can quickly lead to hypomagnesaemia in patients with renal insufficiency

    • Refractory hypokalemia may accompany hypomagnesemia

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Prognosis

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  • • Excellent

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Prevention

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  • • Adequate daily intake

    • Including magnesium in TPN solutions

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References

Kelepouris E et al. Hypomagnesemia: renal magnesium handling. Semin Nephrol. 1998;18:58.  [PubMed: 9459289]
Whang R. Clinical disorders of magnesium metabolism. Compr Ther. 1997;23:168.  [PubMed: 9113454]

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