Department of Medicine, Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand.
Curr Opin Gastroenterol. 2011 Mar;27(2):180-5. doi: 10.1097/MOG.0b013e32833ff5d6.
Hypomagnesaemia has recently been recognized as a rare, but severe, complication of proton pump inhibitor (PPI) use. We reviewed all the cases published to date in peer-reviewed journals to summarize what is known of the epidemiology, risk factors, cause and treatment.
Hypomagnesaemia has been described with all substituted pyridylmethylsulphonyl benzimidazadole derivatives and is a class effect, recurring with substitution of one PPI for another. A long duration of use and high rates of adherence are probably risk factors, but the prevalence is unknown. The diagnosis is often missed, despite the severe symptomatology. Renal magnesium handling is normal, so implicating impairment of net intestinal absorption as the proximate cause. It is not known whether this is the consequence of defective absorption of magnesium through the active or passive transport processes, or increased losses.
PPI-associated hypomagnesaemia is a rare, but potentially life-threatening, side-effect that has emerged only in the era of mass use of these agents. The cause of hypomagnesaemia remains poorly understood, but it responds rapidly to withdrawal of the PPI.
低镁血症最近被认为是质子泵抑制剂（PPI）使用的一种罕见但严重的并发症。我们综述了迄今为止在同行评议期刊上发表的所有病例，总结了其在流行病学、危险因素、病因和治疗方面的已知情况。
所有取代的吡啶甲基磺酰基苯并咪唑类衍生物均可引起低镁血症，这是一种类效应，用一种 PPI 替代另一种 PPI 时会出现这种情况。使用时间长且高的依从性可能是危险因素，但目前尚不清楚其流行程度。尽管有严重的症状，但诊断常常被遗漏。肾脏镁的处理是正常的，因此暗示了净肠内吸收受损是其直接原因。目前尚不清楚这是否是由于主动或被动转运过程中镁的吸收缺陷或丢失增加所致。
PPI 相关性低镁血症是一种罕见但潜在危及生命的副作用，仅在这些药物广泛应用的时代才出现。低镁血症的病因仍不清楚，但停用 PPI 后可迅速缓解。
