ABSTRACT
Magnesium homeostasis is essential for many intracellular processes and depends on the balance of intestinal absorption and renal excretion. Hypomagnesaemia may arise from various disorders. We review the literature on hypomagnesaemia due to the use of proton pump inhibitors, as illustrated by a case of a 76-year-old woman with muscle cramps and lethargy caused by hypomagnesaemia and hypocalcaemia with a low parathyroid hormone level while using esomeprazole, a proton pump inhibitor (PPI). After oral magnesium repletion both abnormalities resolved. Fractional magnesium excretion was low, excluding excessive renal loss. A causal relation with PPI use was supported by the recurrence of hypomagnesaemia after rechallenge. In the past decade our understanding of transcellular magnesium transport was enhanced by the discovery of several gene mutations i.e. transient receptor potential melastin (TR PM) 6 and 7. In this light we discuss the possible aetiology of proton pump inhibitor related hypomagnesaemia.
Subject(s)
Anti-Ulcer Agents/adverse effects , Esomeprazole/adverse effects , Hypocalcemia/chemically induced , Magnesium Deficiency/chemically induced , Proton Pump Inhibitors/adverse effects , Aged , Antacids/administration & dosage , Female , Humans , Hypocalcemia/drug therapy , Magnesium Deficiency/drug therapy , Magnesium Deficiency/genetics , Magnesium Oxide/administration & dosage , Mutation/geneticsABSTRACT
We report a case of Plasmodium vivax malaria in a patient who had not visited an endemic area. The ways in which malaria can be transmitted in non-endemic areas are discussed. By the elimination of other possibilities, the diagnosis of airport malaria was made. Airport malaria is a rare and often initially overlooked diagnosis. Since 1969, some 89 cases of airport malaria have been reported.
