Hypermagnesemia

Hypermagnesemia
Other namesMagnesium toxicity
Magnesium
SpecialtyEndocrinology
SymptomsWeakness, confusion, decreased breathing rate[1]
ComplicationsCardiac arrest[1]
CausesKidney failure, treatment induced, tumor lysis syndrome, seizures, prolonged ischemia[1][2]
Diagnostic methodBlood level > 1.1 mmol/L (2.6 mg/dL)[1][3]
Differential diagnosisKidney failure, high blood calcium, high blood potassium, hypoparathyroidism, hypothyroidism, lithium toxicity, red blood cell breakdown, rhabdomyolysis[4]
TreatmentCalcium chloride, intravenous normal saline with furosemide, hemodialysis[1]
FrequencyUncommon[3]

Hypermagnesemia is an electrolyte disorder in which there is a high level of magnesium in the blood.[3] Symptoms include weakness, confusion, decreased breathing rate, and decreased reflexes. Hypermagnesemia can greatly increase the chances of adverse cardiovascular events. [1][3] Complications may include low blood pressure and cardiac arrest.[1][5]

It is typically caused by kidney failure or is treatment-induced such as from antacids or supplements that contain magnesium.[1][6] Less common causes include tumor lysis syndrome, seizures, and prolonged ischemia.[2] Diagnosis is based on a blood level of magnesium greater than 1.1 mmol/L (2.6 mg/dL).[1][3] It is severe if levels are greater than 2.9 mmol/L (7 mg/dL).[5] Specific electrocardiogram (ECG) changes may be present.[1]

Treatment involves stopping the magnesium a person is getting.[2] Treatment when levels are very high include calcium chloride, intravenous normal saline with furosemide, and hemodialysis.[1] Hypermagnesemia is uncommon.[3] Rates among hospitalized patients in renal failure may be as high as 10%.[2]

  1. ^ a b c d e f g h i j k Soar, J; Perkins, GD; Abbas, G; Alfonzo, A; Barelli, A; Bierens, JJ; Brugger, H; Deakin, CD; Dunning, J; Georgiou, M; Handley, AJ; Lockey, DJ; Paal, P; Sandroni, C; Thies, KC; Zideman, DA; Nolan, JP (October 2010). "European Resuscitation Council Guidelines for Resuscitation 2010 Section 8. Cardiac arrest in special circumstances: Electrolyte abnormalities, poisoning, drowning, accidental hypothermia, hyperthermia, asthma, anaphylaxis, cardiac surgery, trauma, pregnancy, electrocution". Resuscitation. 81 (10): 1400–33. doi:10.1016/j.resuscitation.2010.08.015. PMID 20956045.
  2. ^ a b c d Ronco, Claudio; Bellomo, Rinaldo; Kellum, John A.; Ricci, Zaccaria (2017). Critical Care Nephrology. Elsevier Health Sciences. p. 344. ISBN 9780323511995.
  3. ^ a b c d e f "Hypermagnesemia". Merck Manuals Professional Edition. Retrieved 28 October 2018.
  4. ^ Cascella M, Vaqar S (2020). "Hypermagnesemia". Statspearl. PMID 31747218. This article incorporates text available under the CC BY 4.0 license.
  5. ^ a b Lerma, Edgar V.; Nissenson, Allen R. (2011). Nephrology Secrets. Elsevier Health Sciences. p. 568. ISBN 978-0323081276.
  6. ^ Romani, Andrea, M.P. (2013). "Chapter 3. Magnesium in Health and Disease". In Astrid Sigel; Helmut Sigel; Roland K. O. Sigel (eds.). Interrelations between Essential Metal Ions and Human Diseases. Metal Ions in Life Sciences. Vol. 13. Springer. pp. 49–79. doi:10.1007/978-94-007-7500-8_3. PMID 24470089.{{cite book}}: CS1 maint: multiple names: authors list (link)