Hypomagnesemia

Those at high risk for hypomagnesemia include chronic alcoholics, patients with cirrhosis or who are taking diuretics, malnourished patients, patients requiring tube feeding or total parenteral nutrition, and patients with renal failure. The clinical syndrome of hypomagnesemia is similar to hypocalcemia.

Causes

Secreting too much aldosterone, ADH, or thyroid hormone can cause hypomagnesemia.

Other factors associated with hypomagnesemia include:

• Poor intake (as in alcoholics)
• Poor absorption
• Long-term diuretic therapy
• Hypercalcemia
• Diabetic acidosis
• Acute alcohol consumption.
• Osmotic or saline diuresis
• Primary hyperaldosteronism
• Drugs: diuretics, aminoglycosides, cyclosporine A, tacrolimus, cis-platinum, etc.
• Primary Renal Mg Wasting
• Loss of body fluids as a result of stomach suctioning or chronic diarrhea

Symptoms

• Anorexia
• Nausea and vomiting
• Fatigue
• Irritability
• Generalized weakness

Signs

• Tremor
• Muscular twitching and tetany
• Chvostek's sign
• Trousseau's sign
• Hyporeftexia
• Altered mentation: delirium, hallucinations
• Hypotension and hypothermia (occasional)
• Seizures (usually generalized)

Treatment

• Treat life threatening dysrhythmias according to ACLS protocol or as outlined below if hypomagnesemia is known.
• Perform history, physical examination, and appropriate laboratory tests.
• Treat hypomagnesemia appropriately.