Essrani Rajesh, Mehershahi Shehriyar, Ravi Shri Jai Kirshan, Essrani Rajesh Kumar, Sudhakaran Anuraj, Hossain Muhammad, Yang Tsu Jung, Mehmood Asif
General Internal Medicine, Geisinger Medical Center, Danville, PA USA.
General Internal Medicine, Bronx HealthCare System, Bronx, NY, USA.
Oxf Med Case Reports. 2020 Jan 31;2020(1):omz133. doi: 10.1093/omcr/omz133. eCollection 2020 Jan.
Fifty-five-year-old female with a past medical history of gastroesophageal reflux disease was admitted to hospital due to increased confusion, and muscle cramps for last 15 days. She was taking famotidine 20 mg twice a day for the last 2 years. She was alert and oriented to person and place only. She had dry skin, positive Chvostek's and Trousseau's sign. Blood work showed 141 mmol/L of sodium, 0.7 mg/dl of creatinine, 5.7 mg/dl of calcium, 0.55 mg/dl of magnesium, low PTH but normal parathyroid related peptide PTHrP, vitamin D (25) and vitamin D (1.25). She was discharged home on electrolyte supplements. She was readmitted with very low calcium and magnesium. Extensive workup including 24 h of urine calcium and magnesium was unimpressive. She was treated with IV therapy and discharged to follow up with nephrology in the clinic, and famotidine was discontinued on second discharge. Her calcium and magnesium levels remained normal, and in a few weeks later, oral electrolyte supplements were discontinued.
一名55岁女性，有胃食管反流病病史，因近15天意识模糊加重和肌肉痉挛入院。在过去2年里，她每天服用20毫克法莫替丁两次。她仅对人物和地点有定向力，意识清醒。她有皮肤干燥、Chvostek征和Trousseau征阳性。血液检查显示钠141mmol/L、肌酐0.7mg/dl、钙5.7mg/dl、镁0.55mg/dl，甲状旁腺激素低但甲状旁腺相关肽PTHrP、维生素D（25）和维生素D（1,25）正常。她出院时带了电解质补充剂。她因钙和镁水平极低再次入院。包括24小时尿钙和尿镁在内的全面检查结果不显著。她接受了静脉治疗，出院后到门诊肾病科随访，第二次出院时停用了法莫替丁。她的钙和镁水平保持正常，几周后停用了口服电解质补充剂。
