RESUMEN
A 65 year old alcoholic man was hospitalized because he was tired, hypotonic, with postural tremor. The neurologic symptoms increased during the first two days despite an adequate therapy for alcoholic weaning with hydratation, benzodiazepines and vitamins. A severe hypophosphatemia is diagnosed, associated with hypovitaminosis D, mild hypomagnesemia, mild hypokaliemia and a refeeding syndrome. 24 hours after the normalisation of his phosphatemia, the neurologic symptoms are adjusted.
Asunto(s)
Delirio por Abstinencia Alcohólica/diagnóstico , Delirio por Abstinencia Alcohólica/rehabilitación , Alcoholismo/rehabilitación , Hipopotasemia/diagnóstico , Hipofosfatemia/diagnóstico , Hipofosfatemia/rehabilitación , Deficiencia de Magnesio/diagnóstico , Síndrome de Realimentación/diagnóstico , Síndrome de Realimentación/rehabilitación , Deficiencia de Vitamina D/diagnóstico , Deficiencia de Vitamina D/rehabilitación , Anciano , Terapia Combinada , Diagnóstico Diferencial , Humanos , Hipopotasemia/rehabilitación , Deficiencia de Magnesio/rehabilitación , MasculinoRESUMEN
Magnesium deficiency is common among chronic alcoholics, but the knowledge of oral magnesium supplementation to this group is limited. We, therefore, randomized 49 chronic alcoholics, moderate to heavy drinkers for at least 10 years to receive oral magnesium or placebo treatment for 6 weeks according to a double-blind protocol. Effects on metabolic variables and muscle strength were analyzed. Significant reduction of aspartate-aminotransferase (ASAT), alanine-aminotransferase (ALAT) and gamma-glutamyl-transpeptidase (GGT) were seen after magnesium, whereas no change was observed with placebo. Bilirubin decreased in both groups. Serum Na, Ca, and P increased significantly during magnesium therapy compared with no statistically significant change in the placebo group. Serum K and Mg increased slightly after magnesium supplementation and decreased in the placebo group, resulting in a significant difference between the two groups at the end of the study. Muscle strength increased significantly during magnesium treatment, contrasting to no change with placebo. Blood pressure, heart rate, hematological variables, serum lipids (cholesterol, HDL, TG), glucose tolerance, and creatinine were unchanged in the two groups after treatment. Alcohol consumption was similar before and during the trial and does not explain the differences between the two groups The results shows that short-term oral magnesium therapy may improve liver cell function, electrolyte status, and muscle strength in chronic alcoholics.
