Magnesium

Hypomagnesemia

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Hypomagnesemia, Low Serum Magnesium

  • Causes
  1. Decreased Intake
    1. Protein calorie Malnutrition
    2. Starvation
    3. Alcoholism (Prevalence: 30-80% of Alcoholics)
      1. Among the most common causes of Hypomagnesemia in the Emergency Department
    4. Prolonged IV Therapy
      1. Inadequate parenteral supplementation
  2. Decreased Absorption
    1. Malabsorption (e.g. Celiac Sprue, Crohns Disease)
    2. Small Intestine absorption
    3. Neonatal gut immaturity
  3. Excessive Gastrointestinal losses
    1. Prolonged gastric suction
    2. Laxatives
    3. Intestinal or biliary fistula
    4. Severe Diarrhea
  4. Excessive Renal Losses
    1. Diuretics
    2. Acute Tubular Necrosis (Diuretic phase)
    3. Acute Renal Failure diuresis
    4. Primary Aldosteronism
    5. Hypercalcemia
    6. Renal Tubular Acidosis (RTA)
    7. Idiopathic renal wasting
    8. Chronic Renal Failure with wasting
  5. Miscellaneous Causes
    1. Idiopathic
    2. Acute Pancreatitis
    3. Porphyria with SIADH
    4. Multiple transfusions with citrated blood
  6. Endocrine
    1. Hyperthyroidism
    2. Hyperparathyroidism
    3. Poorly controlled Diabetes Mellitus and Diabetic Ketoacidosis
    4. Hyperaldosteronism
  7. Medications
    1. Cisplatin
    2. Cyclosporin
    3. Gentamycin
    4. Ticarcillin
    5. Carbenicillin
  • Symptoms
  1. Loss of appetite
  2. Nausea or Vomiting
  3. Fatigue
  4. Weakness
  5. Vertigo
  6. Dysphagia
  7. Parasthesias
  • Signs
  1. Seizures
  2. Muscle cramps to Tetany
  3. Chvostek's Signs
  4. Vertical Nystagmus
  5. Arrhythmias
  • Management
  1. See Magnesium Replacement