Service de Médecine Interne, Internal medicine Department, Georges Pompidou European Hospital, AP-HP, 20 rue Leblanc, 75015, Paris, France.
Faculté de Médecine Paris Descartes, Sorbonne Paris-Cité, Paris, France.
Intern Emerg Med. 2018 Dec;13(8):1201-1209. doi: 10.1007/s11739-018-1898-7. Epub 2018 Jun 27.
Extreme hypomagnesemia (hypoMg) can be encountered in many situations, but little data currently exist. Our aim is to describe the epidemiological, clinical, etiological characteristics, and the biological abnormalities of consecutive inpatients with extreme hypomagnesemia. In our observational monocentric study, between 1st July 2000 and April 2015, all inpatients with extreme hypomagnesemia, defined by at least one plasma magnesium concentration (P) below 0.3 mmol/L, were included. Demographic, clinical, biological characteristics and the drugs prescribed before the qualifying P measurement were retrospectively collected. 41,069 patients had at least one P assessment. The prevalence of extreme hypomagnesemia is 0.3% (119 inpatients). The median age is 70 years, 52% are women. The patients were mainly hospitalized in intensive care (n = 37, 31.1%), oncology (n = 21, 17.6%), gastroenterology (n = 18, 15.1%) and internal medicine (n = 16, 13.4%) departments. One hundred patients (84%) had a medical history of gastrointestinal disease (39% with bowel resections, 24% with stoma), and 50 (42%) had a cancer history. The drugs most commonly prescribed (known to induce hypoMg) are proton pump inhibitors (PPI) (n = 77, 70%), immunosuppressive regimens (n = 25, 22.5%), platinum salt-based chemotherapies (n = 19, 17.1%), and diuretics (n = 22, 19.8%). The suspected causes of hypomagnesemia are often multiple, but drugs (46%, including PPI in 19%) and chronic gastrointestinal disorders (37%) are prominent. Associated electrolyte disturbances include hypocalcemia (77%) and mild hypokalemia (51%). The 1-month mortality from all causes is 16%. Extreme hypomagnesemia is rare in inpatients, and is frequently associated with severe hypocalcemia. Digestive disorders and drugs are the main contributory causes.
极端低镁血症（hypoMg）可发生在许多情况下，但目前数据很少。我们的目的是描述连续住院的极端低镁血症患者的流行病学、临床、病因特征和生物学异常。在我们的观察性单中心研究中，于 2000 年 7 月 1 日至 2015 年 4 月，将所有至少有一次血浆镁浓度（P）低于 0.3mmol/L 的极端低镁血症住院患者纳入研究。回顾性收集人口统计学、临床、生物学特征以及在符合条件的 P 测量前开具的药物。41069 名患者至少有一次 P 评估。极端低镁血症的患病率为 0.3%（119 例住院患者）。中位年龄为 70 岁，52%为女性。患者主要住院于重症监护病房（n=37，31.1%）、肿瘤科（n=21，17.6%）、胃肠病科（n=18，15.1%）和内科（n=16，13.4%）。100 例（84%）有胃肠道疾病病史（39%有肠切除术，24%有造口术），50 例（42%）有癌症病史。最常开的药物（已知会引起低镁血症）是质子泵抑制剂（PPI）（n=77，70%）、免疫抑制方案（n=25，22.5%）、铂盐化疗（n=19，17.1%）和利尿剂（n=22，19.8%）。低镁血症的可疑原因往往是多种，但药物（46%，包括 19%的 PPI）和慢性胃肠道疾病（37%）是突出的。伴发的电解质紊乱包括低钙血症（77%）和轻度低钾血症（51%）。所有原因的 1 个月死亡率为 16%。住院患者的极端低镁血症很少见，常伴有严重低钙血症。消化道疾病和药物是主要的致病原因。
