Hypomagnesemia

• • Low serum magnesium

Epidemiology

• • 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

Symptoms and Signs

• • Hyperactive deep tendon reflexes

  • Positive Chvostek sign

  • Tremors

  • Delirium

  • Convulsions

Laboratory Findings

• • Low serum magnesium

• • Depends on clinical suspicion and serum levels

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

• • Administering supplemental magnesium

  • PO replacement for minor to moderate hypomagenesemia

  • For severe deficits: IV magnesium sulfate

Complications

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

  • Refractory hypokalemia may accompany hypomagnesemia

Prognosis

• • Excellent

Prevention

• • Adequate daily intake

  • Including magnesium in TPN solutions

References