Clinical study on magnesium and calcium level in the blood during the acute pancreatitis.

The aim of this clinical study was to determine whether during the course of mild gallstone pancreatitis (I degree), which is the most common form of acute pancreatitis, there occur blood magnesium and calcium concentration disruptions. Testing was performed on 20 patients suffering from mild pancreatitis during 5 days of illness. Results were compared with a group of 110 healthy individuals (first-time blood donors). The average plasma magnesium ion concentration (PMg++) was lowest in the first day of illness and gradually goes up during the following 4 days. The highest levels, exceeding 11 per cent basal values, were observed during the fifth day of acute pancreatitis. Similar changes of blood cells magnesium ion concentration (BCMg++) were observed. The lowest level was found during the first day and after this it increased slightly to reach average levels. The most stable was plasma calcium ion concentration (PCa++) which did not indicate any variations. Blood donors results: PMg++ mean 0.95 +/- 0.17 mmol/L (range 0.65-1.41 mmol/L), BCMg++ -2.85 +/- 0.42 mmol/L (1.58-3.62 mmol/L), PCa++ -2.51 +/- 0.28 mmol/L (2.03-2.99 mmol/L). The observed differences in magnesium concentration were statistically significant only for the group examined (p < 0.001) and did not differ in a statistically significant sense from the control group values (Cohran-Cox test with p < 0.001). Previous studies have shown that, among individuals with mild gallstone pancreatitis, there is half the bile magnesium ion concentration and the same bile calcium ion concentration as among individuals with gallstones, who have not suffered from pancreatitis. Lack of permanent blood ion changes during the course of this form of the disease shows that the general circulating pool is unchanged. This magnesium deficiency pertains specifically to bile. However during the course of acute pancreatitis and lack of oral magnesium supply the pool of body reserves may be depleted. Magnesium also shows pharmacodynamic action as a tranquilliser, a vasodilator, a cytoprotective agent, an anticoagulant, an antioxidant and a myorelaxant. All these influences are beneficial in acute pancreatitis treatment. Therefore, despite visible features of magnesium deficit in the organism, it seems reasonable to supply the daily need by adding 2 amp. 25 per cent magnesium sulphate (total 40.5 mmol) during parenteral fluids infusion. Such a procedure was carried out for our patients and the results will be presented in a separate publication.