Miri Mahdieh, Esmailsorkh Farhad, Farhadi Ehsan, Rahimi Mitra
Department of Internal Medicine, Saveh University of Medical Science, Saveh, Markazi, Iran.
School of Medicine, Shahid Beheshti University of Medical Science, Tehran, Iran.
J Med Case Rep. 2025 Jul 22;19(1):357. doi: 10.1186/s13256-025-05430-9.
Magnesium toxicity occurs mostly in patients with decreased renal function or in preeclamptic patients who underwent high-dose magnesium sulfate therapy. Iatrogenic injection of magnesium sulfate is a rare condition. Magnesium sulfate extensively influences heart, lung, and brain function. Therefore, it is crucial to manage magnesium sulfate overdose through intensive procedures if common treatments do not improve the patient's prognosis. Our paper focuses on a case study of a patient who overdosed on magnesium sulfate and was managed through hemodialysis.
A 50-year-old Iranian woman was admitted to the hospital, following the injection of two vials of magnesium sulfate (25 g each) by emergency medicine services mistakenly, instead of the vial of glucose. At the entrance of the emergency ward, she became pulseless, and they initiated cardiopulmonary resuscitation and intubation. Electrocardiogram and laboratory results showed hypermagnesemia. Primary supportive interventions-fluid therapy and calcium gluconate injections-were ineffective in halting the progression of the patient's symptoms. Therefore, we decided to initiate hemodialysis, which significantly improved the patient's symptoms. Consequently, she improved and was discharged from the intensive care unit and the hospital.
Hypermagnesemia is a life-threatening and emergency condition that must be recognized and managed immediately. Hemodialysis should be considered promptly if basic supportive interventions such as calcium gluconate and fluid therapy are ineffective in treating hypermagnesemia.
镁中毒主要发生在肾功能减退的患者或接受大剂量硫酸镁治疗的先兆子痫患者中。医源性注射硫酸镁是一种罕见情况。硫酸镁会广泛影响心脏、肺和脑功能。因此，如果常规治疗不能改善患者预后，通过强化措施处理硫酸镁过量至关重要。我们的论文重点关注了一例硫酸镁过量患者并通过血液透析进行治疗的病例研究。
一名50岁的伊朗女性因急诊医疗服务误将两瓶硫酸镁（每瓶25克）而非葡萄糖瓶注射后入院。在急诊病房入口处，她心跳骤停，随后开始进行心肺复苏和插管。心电图和实验室检查结果显示高镁血症。主要的支持性干预措施——液体治疗和葡萄糖酸钙注射——未能阻止患者症状的进展。因此，我们决定开始血液透析，这显著改善了患者的症状。随后，她病情好转，从重症监护病房出院并出院。
高镁血症是一种危及生命的紧急情况，必须立即识别并处理。如果葡萄糖酸钙和液体治疗等基本支持性干预措施在治疗高镁血症时无效，应立即考虑进行血液透析。
