Sato Takanobu, Ohashi Ryogo, Konishi Katsuya, Cho Teuon, Ichibayashi Ryo
Division of Emergency Medicine, Department of Internal Medicine, Toho University Sakura Medical Center, Sakura, JPN.
Cureus. 2025 Jan 1;17(1):e76727. doi: 10.7759/cureus.76727. eCollection 2025 Jan.
Long-term administration of proton pump inhibitors (PPIs) has been increasingly recognized to cause hypomagnesemia due to impaired magnesium absorption in both the small and large intestines. Hypomagnesemia can lead to various electrolyte imbalances, including hypokalemia, hypocalcemia, and, less commonly, hyponatremia and hypophosphatemia. Measuring serum magnesium levels is essential for identifying the underlying cause in patients receiving PPIs with unexplained electrolyte abnormalities. Currently, no standardized treatment exists for PPI-induced hypomagnesemia beyond discontinuing PPI therapy and administering magnesium supplements. The main preventive strategies in managing acid-related diseases may be a case-by-case endoscopic evaluation and early discontinuation of PPIs. This report describes a case of multiple electrolyte abnormalities, including hypomagnesemia, associated with PPI use. It highlights that serum magnesium levels may require several weeks to return to baseline following PPI discontinuation. In outpatient management, repeated serum magnesium measurements over several months are necessary rather than relying on a single assessment post-discontinuation. Furthermore, among the affected electrolytes, magnesium normalization is the most delayed, underscoring the importance of monitoring serum magnesium levels to assess treatment efficacy in cases of complex electrolyte disturbances.
长期服用质子泵抑制剂（PPI）已越来越多地被认为会导致低镁血症，原因是小肠和大肠对镁的吸收受损。低镁血症可导致各种电解质失衡，包括低钾血症、低钙血症，较少见的还有低钠血症和低磷血症。对于接受PPI治疗且出现不明原因电解质异常的患者，测定血清镁水平对于确定潜在病因至关重要。目前，除了停用PPI治疗并补充镁剂外，尚无针对PPI诱导的低镁血症的标准化治疗方法。在管理酸相关疾病时，主要的预防策略可能是根据具体情况进行内镜评估并尽早停用PPI。本报告描述了一例与使用PPI相关的多种电解质异常病例，包括低镁血症。它强调停用PPI后血清镁水平可能需要数周才能恢复到基线。在门诊管理中，需要在几个月内多次测量血清镁，而不是仅依赖停用后的单次评估。此外，在受影响的电解质中，镁的恢复正常最为延迟，这突出了监测血清镁水平以评估复杂电解质紊乱病例治疗效果的重要性。
