Magnesium poisoning, multi-organ failure and ischemic colitis secondary to chronic ingestion of a parapharmacy product.

The article describes the clinical case of a patient with multi-organ failure and ischemic colitis secondary to magnesium poisoning, due to the chronic intake of a parapharmacy product, used for the treatment of chronic constipation. The clinical case is described and a review of the literature is made.

[Magnesium homeostasis disorders: hypermagnesemia]. / Zaburzenia homeostazy magnezu: hipermagnezemia mia.

Hypermagnesemia, defined as a plasma total magnesium concentration greater than 1.2 mmol/l, is much less common than hypomagnesemia, however it may be also life-threatening. In this review causes, clinical presentation and treatment of hypermagnesemia is shortly reviewed.

A case report: magnesium intoxication occurring in the process of total serum magnesium decrease.

Magnesium intoxication is a result of excessively high serum magnesium levels, which are generally represented by a patient's total serum magnesium concentration. This is the first case report in PubMed in which a female patient showed no signs of magnesium intoxication when her total serum magnesium concentration was 4.34 mg/dL, but showed signs of magnesium intoxication (i.e. absent-patellar reflex) when the concentration was 3.66 mg/dL. We concluded that the serum magnesium level cannot be represented by the total serum magnesium concentration to a full extent; a lower total serum magnesium concentration may still lead to magnesium intoxication.

[Intoxication with magnesium, a 'forgotten' electrolyte]. / Intoxicatie met magnesium, een 'vergeten' elektrolyt.

Magnesium salts are widely used and are usually regarded as rather harmless. Magnesium intoxication, however, can be lethal. Recently, severe magnesium intoxication was identified in 3 patients, one woman aged 68 and 2 men aged 19 and 26 years respectively, who required treatment in an Intensive Care setting. Initial symptoms of magnesium intoxication went unnoticed due to sedation or paraplegia. Only after developing severe neurological symptoms, respiratory or circulatory failure, magnesium intoxication was diagnosed. Plasma magnesium levels exceeded 6 mmol/l (reference value: 0.70-1.00). Therapy consisted of cessation of magnesium therapy, administration of calcium and enhanced elimination of magnesium by haemodialysis. All patients survived the intoxication. Magnesium intoxication may develop unnoticed when the initial signs and symptoms are masked by clinical conditions. Especially patients with renal failure, inflammatory bowel disease, sedation and paraplegia need careful monitoring when magnesium is administered.

Increased water hardness and magnesium levels may increase occurrence of urolithiasis in cows from the Burdur region (Turkey).

Objectives of the study were to measure water hardness in Burdur, and to establish its possible association with urolithiasis in cattle. Water samples were obtained from different stables (n = 15). Water hardness and the concentrations of potassium, calcium, magnesium, sodium, iron, zinc, manganese and copper ions were calculated from these water samples. Total hardness of the samples (mean 285 ppm) exceeded the standards and the water was characterized by high content of magnesium ions. Kidneys (n = 500) were collected randomly from slaughterhouses and examined for urolithiasis. Urolithiasis was observed in 102 kidneys (20.4%). The weights of the stones were between 0.02 and 237.44 g and the colour varied from white to brown. The calculi collected had various shapes and composed of calcium apatite (42.45%), struvite (20.15%), magnesium carbonate (15.15%), calcium carbonate (12.12%), and calcium phosphate cystine (10.13%). It was concluded that high water hardness with high magnesium ion concentrations in water may contribute to urolithiasis and needs to be investigated further in future studies.

Skeletal demineralization and fractures caused by fetal magnesium toxicity.

Two surviving female infants, born from a triplet pregnancy at 30 weeks gestation, were noted to have severe osteopenia and multiple fractures diagnosed at 20 days of age. Their mother had been treated for preterm labor with intravenous magnesium sulfate from week 22 until their birth at 30 weeks gestation. At birth, the triplets exhibited craniotabes with enlarged fontanelles and sutures. All developed Respiratory Distress Syndrome (RDS) and the two surviving infants required prolonged respiratory support. Serum calcium and phosphate levels were normal and alkaline phosphatase levels were increased. The infants were treated with supplements of calcium and phosphorous, with resultant healing of the multiple fractures without deformity. Fetal magnesium toxicity impairs bone mineralization and can lead to serious bone demineralization that may cause fractures in the newborn period that complicate recovery from respiratory disease. Early recognition and treatment may minimize complications related to osteopenia caused by fetal magnesium toxicity.

Cations and hypertension: sodium, potassium, calcium, and magnesium.

The association between sodium intake and hypertension has been studied for almost a century. More recently, it has been suggested that abnormalities in dietary intake of potassium, calcium, and magnesium may play a major role in the pathogenesis of hypertension. A critical analysis of selected data from animal and human studies is discussed.

Acute hypermagnesemia: a rare complication of antacid administration after bone marrow transplantation.

INTRODUCTION: We reported a case of hypermagnesemia in whom hypotension, hypothermia, and coma developed after repetitive doses of a seemingly harmless antacid for epigastric pain following bone marrow transplantation. METHODS: For this case, serial electrolytes, blood urea nitrogen, creatinine, calcium, and magnesium were obtained. Issues addressed were the restoration of normal hydration by normal saline, together with forced diuresis to hasten the renal excretion of magnesium, and eventual changes in its levels. RESULTS: The highest measured magnesium concentration was 5.9 mmol/l. She recovered without dialysis. The patient's condition improved with intravenous doses of calcium gluconate, saline solution infusion, and cardiovascular support. CONCLUSION: Hypermagnesemia is rare in allogeneic stem cell recipients receiving cyclosporine therapy for prevention of acute graft-vs.-host disease (GVHD). A posttransplant status with possible GVHD, poor nutritional intake, impaired intestinal absorption, dehydration, and the use of aluminum magnesia oral suspension may have resulted in magnesium imbalance. This case report highlights several associated nonrenal risk factors for hypermagnesemia, which include gastrointestinal tract disease, dehydration, and concomitant medications, particularly, the antacids that contain magnesium.

[Clinical and biochemical aspects of loading heifers with magnesium flue dust]. / Klinicko-biochemické aspekty zátaze jalovíc magnezitovým úletom.

The objective of the paper was to investigate clinical and laboratory findings in heifers subjected to magnesite flue dust stress. A 50-day experiment was conducted in clinical conditions on five two-year heifers of the Slovak and Red Pied breeds at the live weight of 331 to 420 kg. All animals received dietary Mg from the source of magnesite flue dust at a rate of 500 mg/kg live weight. The test flue dust came from dust separation from electrostatic filters and contained these main elements: Mg (88%), Ca (1.6%), K (0.36%), Na (0.26%), Fe (1.89%), Zn (0.0026%), Cu (0.000294%) and trace amount of P. The clinical health of the animals was evaluated daily. Samples of blood, urine and dung were taken before the first administration of flue dust, on days 12, 30 and 50 of the experiment. The counts of erythrocytes, leucocytes, hemoglobin concentration and hematocrit value were determined in blood. Enzyme activities (AST, ALT, GMT), concentrations of total bilirubin, albumin, total proteins and total immunoglobulins were determined in blood serum. Contents of Mg, Ca, P, K, Na, Fe, Cu and Zn in blood serum, urine, dung and of the test pollutant were determined by atomic absorption spectrophotometry on a Perkin Elmer apparatus (model 306, 1100). Profuse diarrhea was a dominant clinical symptom in the animals which appeared in individual animals between 24th and 48th hour from the first intake of magnesite flue dust. Diarrhea lasted alternately in all heifers until day 50 of the experiment. As for the analyzed parameters of hematological profile during administration of the pollutant (Figs. 1-4), Hb and Hk (P < 0.01) increased significantly in the investigated animals on day 12 in comparison with the initial values. Out of the enzymes, AST and ALT activities showed most readily the feeding of magnesite flue dust (r = 0.99 and r = 0.92, resp.), Figs. 5 and 6. Correlation relationships between magnesite pollutant administration and bilirubinemia dynamics during the experiment indicated the correlation r = 0.53 (Fig. 8), r = 0.36 (Fig. 9) for total proteins, r = 0.75 (Fig. 10) for albumin and r = 0.93 (Fig. 11) for total immunoglobulins. In comparison with the initial values, Mg concentrations in blood serum and dung significantly increased from day 12 of experiment (P < 0.01 - Fig. 13) and in urine from day 30 (P < 0.05).(ABSTRACT TRUNCATED AT 400 WORDS)

[Severe mixed poisoning with diltiazem, potassium and magnesium: a case report]. / Ciezkie zatrucie mieszane diltiazemem, potasem i magnezem--opis przypadku.

We report the case of 52-year-old woman, who ingested 3.6 g of diltiazem, 16 g of potassium chloride and 6.5 g of magnesium, in a suicide attempt 4 hours before admission. She developed cardiorespiratory failure, with severe hypotonia and acute renal failure, in ECG third degree atrioventricular block was stated. The highest potassium concentration was 8.0 mmol/l, magnesium 2.15 mmol/l. As a result of multiple pharmacologic intervention, including intravenous fluids, calcium, glucagon, dopamine, dobutamine, norepinephrine, transvenous pacing and peritoneal dialysis (haemodynamic instability makes haemodialysis noneffective) the haemodynamic stabilization of cardiovascular system and normalization of potassium and magnesium concentration were achieved. The diltiazem concentration was measured using liquid chromatography, the result was 0.89 microgram/ml. She was discharged in a good clinical condition on day 26th.

[Anabolic effects of sodium selenite, vitamin E and retabolil in experimental hypotrophy induced by a pesticide]. / Anabolicheskii éffekt selenita natriia, vitamina E, retabolila na fone éksperimental'noi gipotrofii, vyzvannoi pestitsidom.

Forty Chinchilla rabbits of both sexes were examined for changes in some parameters of protein, lipid and trace elements metabolism (total protein, protein fractions, urea, residual nitrogen in blood serum, lipids, total cholesterol, free cholesterol, diglycerides, phospholipids, triglycerides, free fatty acids and the trace elements selenium, iron, zinc and so forth in the liver) during the animals' poisoning with the defoliant magnesium chlorate. A study was made of the effect on these changes of the administration for 3 weeks of sodium selenite (15 micrograms/kg), vitamin E (25 mg/kg) and retabolil (2 mg/kg once a week). It has been established that the combined administration of these agents removes and prevents the changes in protein, lipid and trace elements (hypoproteinemia, dysproteinemia and impairment of the nitrous balance) and lipid metabolism because of the animals' poisoning with magnesium chlorate.

Hypermagnesemia accompanied with colonic perforation in a hemodialysis patient.

We report a case of a chronic hemodialysis patient who developed hypermagnesemia due to an overdose of magnesium-containing laxative and paralytic ileus resulting in colonic perforation. Despite intravenous calcium infusion and daily hemodialysis, the patient developed ischemic colitis and intestinal perforation. Colonic perforation accompanied with hypermagnesemia in hemodialysis patients has rarely been reported. This case suggests that hypermagnesemia should be considered in renal failure patients as this can result in life-threatening events despite prompt treatment.