A Case of Severe Proton Pump Inhibitor-Induced Hypomagnesemia Refractory to Continuous Oral and Intravenous Magnesium Replenishment.
Level 4 - case-series / case-control
Single patient case report
PubMed 38516446 · doi:10.7759/cureus.54483
What was done
Clinical case report of a 70-year-old male with a long history of chronic proton pump inhibitor (PPI) use for persistent epigastric pain who experienced recurrent, treatment-resistant hypomagnesemia across 10 hospital admissions.
What was found
The abstract provides no exact numerical values for serum magnesium concentrations, drug dosages, or treatment timelines. It reports that across 10 hospital admissions, the patient presented with symptoms of severe hypomagnesemia including nausea, muscle fasciculations, diffuse cramps, weakness, neuromuscular irritability, and non-specific T-wave abnormalities on ECG, all of which were refractory to continuous oral and intravenous magnesium replenishment.
Why it matters
This report highlights that chronic PPI therapy can lead to severe hypomagnesemia that fails to respond to oral or intravenous magnesium supplementation until the medication is recognized and discontinued.
Limits
This is an uncontrolled single-patient case report (n=1), preventing generalization. The abstract omits specific quantitative laboratory measurements, the specific PPI agent and dosage, and quantitative follow-up parameters.
Cited by
- supports Muscle relaxation is mediated by a magnesium-fueled pump that pumps calcium out of the cell, and magnesium deficiency impairs this pump, resulting in muscle twitches, cramps, and jaw clenching.