Introduction
Hypomagnesemia(hypomagnesemia) refers to a disease state caused by a deficiency of magnesium in the body. Simple hypomagnesemia is rare, and healthy people are not prone to magnesium deficiency. However, in non-healthy people with various diseases, hypomagnesemia is common, especially in patients who are malnourished, use diuretics, use certain antibiotics, and have low albumin.
Common causes of hypomagnesemia include:
(1) Insufficient intake of magnesium: lack of magnesium in the diet, or malnutrition caused by diseases that cannot be eaten normally.
(2) various intestinal diseases: diarrhea, vomiting, steatorrhea, intestinal dysfunction leading to malabsorption, intestinal resection, small intestine bypass surgery.
(3) various kidney diseases: such as recovery period of acute kidney injury, after kidney transplantation.
(4) Long-term use of proton pump inhibitors (the name of the drug is usually "XX pullazole") for more than one year.
(5) Use of diuretics: such as furosemide, hydrochlorothiazide, and the like.
(6) Use drugs that are toxic to the kidneys: such as streptomycin, kanamycin, gentamicin, neomycin, amphotericin B, cisplatin, pentamidine, cyclosporine,Cetuximab,Panitumab, Martuzumab and so on.
(7) Alcoholism.
(8) Diabetes blood glucose control is poor.
(9) Hypercalcemia: such as primary hyperparathyroidism.
(10) Family genetic diseases: such as primary intestinal hypomagnesemia,Gitelman syndrome, familial hypomagnesemia combined with hypercalciuria and renal calciumosis (FHHNC). Hypomagnesemia caused by familial genetic diseases is not common.
In addition to hypomagnesemia caused by family genetic diseases, other hypomagnesemia is generally not inherited.
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Hypomagnesemia can be manifested as tremor, hand and foot sputum, convulsions (white eyes, foaming of mouth and mouth, stiff hands and feet, etc.), muscle weakness, apathy, convulsions (sudden screams, behavioral disorders, day and night upside down, hallucinations) And auditory hallucinations, etc.), coma, etc.
complication:
Hypoparathyroidism, vitamin D deficiency and hypocalcemia: manifested as hand and foot convulsions, bone loss.
Arrhythmia: such as premature beats, atrial fibrillation, etc.
epilepsyattack.
(2) Concurrent diseases:
Hypokalemia: It can manifest as muscle weakness, paralysis, palpitation, etc.
Insulin resistance: causes abnormal blood sugar.
hypertension.
Migraine attack.
asthmaattack.
(1) Blood draw: Determine the blood magnesium level, determine whether there is hypomagnesemia, and simultaneously measure electrolytes such as blood calcium and blood potassium. In patients with hypomagnesemia, magnesium, calcium and potassium are usually low.
(2) Electrocardiogram examination: QRS wave broadening and T wave high tip appear in mild hypomagnesemia; severe PR interval prolongation, T wave low level and various arrhythmias occur in severe hypomagnesemia.
(3) Retention of urine: Determination of urinary magnesium levels, preliminary determination of the cause of hypomagnesemia. If it is hypomagnesemia caused by kidney disease, urinary magnesium is usually high; if it is non-kidney disease caused by hypomagnesemia, urinary magnesium is usually low.
(1) magnesium treatment: patients with obvious symptoms (such as the presence of hand, foot and ankle, arrhythmia or seizures), need to use intravenous drugs to supplement magnesium, and cardiac monitoring, commonly used drugs are magnesium sulfate. Patients with no symptoms can be supplemented with magnesium by oral medication. Commonly used drugs are magnesium chloride, magnesium lactate, magnesium oxide and the like.
(2) Eliminate the cause: such as restoring normal diet, treating intestinal diseases, treating kidney disease, controlling blood sugar, and abstaining from alcohol.
After magnesium supplementation, blood magnesium levels can usually return to normal quickly. For patients with normal renal function, it is necessary to continue magnesium supplementation for 1 to 2 days after the blood magnesium returns to normal; for patients with abnormal renal function, magnesium supplementation should be extra cautious and should not be supplemented for too long.
The drugs for treating hypomagnesemia are mainly various magnesium preparations. Magnesium supplementation by oral administration is prone to side effects such as gastrointestinal discomfort and diarrhea. In addition, if the patient has abnormal renal function, hypermagnesemia is prone to occur during magnesium supplementation, which is characterized by facial flushing, decreased tendon reflex, decreased blood pressure, and arrhythmia (atrioventricular block).
Patients with obvious symptoms of hypomagnesemia need hospitalization, magnesium supplementation by infusion, and cardiac monitoring during treatment.
Patients with asymptomatic hypomagnesemia can be treated in an outpatient setting and supplemented with magnesium by oral administration.
Since healthy people are not prone to magnesium deficiency, most of the hypomagnesemia occurs in patients with various diseases, so the prevention of hypomagnesemia is mainly the work of doctors. When doctors treat various patients or use various drugs, they should anticipate the risk of hypomagnesemia. They should introduce the symptoms and manifestations of hypomagnesemia and urge patients to check blood magnesium regularly.
After magnesium supplementation, blood magnesium levels can usually return to normal quickly. If the cause of hypomagnesemia is not removed, it may recur.
meeting. However, hypomagnesemia is easy to correct and can be considered after physical recovery.
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