PMID- 29951810 OWN - NLM STAT- MEDLINE DCOM- 20190528 LR - 20190528 IS - 1970-9366 (Electronic) IS - 1828-0447 (Linking) VI - 13 IP - 8 DP - 2018 Dec TI - Extreme hypomagnesemia: characteristics of 119 consecutive inpatients. PG - 1201-1209 LID - 10.1007/s11739-018-1898-7 [doi] AB - Extreme hypomagnesemia (hypoMg) can be encountered in many situations, but little data currently exist. Our aim is to describe the epidemiological, clinical, etiological characteristics, and the biological abnormalities of consecutive inpatients with extreme hypomagnesemia. In our observational monocentric study, between 1st July 2000 and April 2015, all inpatients with extreme hypomagnesemia, defined by at least one plasma magnesium concentration (P(Mg)) below 0.3 mmol/L, were included. Demographic, clinical, biological characteristics and the drugs prescribed before the qualifying P(Mg) measurement were retrospectively collected. 41,069 patients had at least one P(Mg) assessment. The prevalence of extreme hypomagnesemia is 0.3% (119 inpatients). The median age is 70 years, 52% are women. The patients were mainly hospitalized in intensive care (n = 37, 31.1%), oncology (n = 21, 17.6%), gastroenterology (n = 18, 15.1%) and internal medicine (n = 16, 13.4%) departments. One hundred patients (84%) had a medical history of gastrointestinal disease (39% with bowel resections, 24% with stoma), and 50 (42%) had a cancer history. The drugs most commonly prescribed (known to induce hypoMg) are proton pump inhibitors (PPI) (n = 77, 70%), immunosuppressive regimens (n = 25, 22.5%), platinum salt-based chemotherapies (n = 19, 17.1%), and diuretics (n = 22, 19.8%). The suspected causes of hypomagnesemia are often multiple, but drugs (46%, including PPI in 19%) and chronic gastrointestinal disorders (37%) are prominent. Associated electrolyte disturbances include hypocalcemia (77%) and mild hypokalemia (51%). The 1-month mortality from all causes is 16%. Extreme hypomagnesemia is rare in inpatients, and is frequently associated with severe hypocalcemia. Digestive disorders and drugs are the main contributory causes. FAU - Cheminet, Geoffrey AU - Cheminet G AD - Service de Medecine Interne, Internal medicine Department, Georges Pompidou European Hospital, AP-HP, 20 rue Leblanc, 75015, Paris, France. AD - Faculte de Medecine Paris Descartes, Sorbonne Paris-Cite, Paris, France. FAU - Clain, Gabrielle AU - Clain G AD - Faculte de Medecine Paris Descartes, Sorbonne Paris-Cite, Paris, France. AD - Medical Information Department, Georges Pompidou European Hospital, AP-HP, Paris, France. FAU - Jannot, Anne-Sophie AU - Jannot AS AD - Faculte de Medecine Paris Descartes, Sorbonne Paris-Cite, Paris, France. AD - Medical Information Department, Georges Pompidou European Hospital, AP-HP, Paris, France. FAU - Ranque, Brigitte AU - Ranque B AD - Service de Medecine Interne, Internal medicine Department, Georges Pompidou European Hospital, AP-HP, 20 rue Leblanc, 75015, Paris, France. AD - Faculte de Medecine Paris Descartes, Sorbonne Paris-Cite, Paris, France. FAU - Passeron, Amelie AU - Passeron A AD - Service de Medecine Interne, Internal medicine Department, Georges Pompidou European Hospital, AP-HP, 20 rue Leblanc, 75015, Paris, France. AD - Faculte de Medecine Paris Descartes, Sorbonne Paris-Cite, Paris, France. FAU - Michon, Adrien AU - Michon A AD - Service de Medecine Interne, Internal medicine Department, Georges Pompidou European Hospital, AP-HP, 20 rue Leblanc, 75015, Paris, France. AD - Faculte de Medecine Paris Descartes, Sorbonne Paris-Cite, Paris, France. FAU - De Luna, Gonzalo AU - De Luna G AD - Service de Medecine Interne, Internal medicine Department, Georges Pompidou European Hospital, AP-HP, 20 rue Leblanc, 75015, Paris, France. AD - Faculte de Medecine Paris Descartes, Sorbonne Paris-Cite, Paris, France. FAU - Diehl, Jean-Luc AU - Diehl JL AD - Faculte de Medecine Paris Descartes, Sorbonne Paris-Cite, Paris, France. AD - Medical Intensive Care Department, Georges Pompidou European Hospital, AP-HP, Paris, France. FAU - Oudard, Stephane AU - Oudard S AD - Faculte de Medecine Paris Descartes, Sorbonne Paris-Cite, Paris, France. AD - Oncology Department, Georges Pompidou European Hospital, AP-HP, Paris, France. FAU - Cellier, Christophe AU - Cellier C AD - Faculte de Medecine Paris Descartes, Sorbonne Paris-Cite, Paris, France. AD - Gastroenterology Department, Georges Pompidou European Hospital, AP-HP, Paris, France. FAU - Karras, Alexandre AU - Karras A AD - Faculte de Medecine Paris Descartes, Sorbonne Paris-Cite, Paris, France. AD - Nephrology Department, Georges Pompidou European Hospital, AP-HP, Paris, France. FAU - Vedie, Benoit AU - Vedie B AD - Biochemistry Department, Georges Pompidou European Hospital, AP-HP, Paris, France. FAU - Prot-Bertoye, Caroline AU - Prot-Bertoye C AD - Faculte de Medecine Paris Descartes, Sorbonne Paris-Cite, Paris, France. AD - Renal Physiology Department, Georges Pompidou European Hospital, AP-HP, Paris, France. FAU - Pouchot, Jacques AU - Pouchot J AD - Service de Medecine Interne, Internal medicine Department, Georges Pompidou European Hospital, AP-HP, 20 rue Leblanc, 75015, Paris, France. AD - Faculte de Medecine Paris Descartes, Sorbonne Paris-Cite, Paris, France. FAU - Arlet, Jean-Benoit AU - Arlet JB AD - Service de Medecine Interne, Internal medicine Department, Georges Pompidou European Hospital, AP-HP, 20 rue Leblanc, 75015, Paris, France. jean-benoit.arlet@aphp.fr. AD - Faculte de Medecine Paris Descartes, Sorbonne Paris-Cite, Paris, France. jean-benoit.arlet@aphp.fr. LA - eng PT - Journal Article PT - Observational Study DEP - 20180627 PL - Italy TA - Intern Emerg Med JT - Internal and emergency medicine JID - 101263418 RN - 0 (Diuretics) RN - 0 (Proton Pump Inhibitors) RN - I38ZP9992A (Magnesium) RN - Hypomagnesemia primary SB - IM CIN - Intern Emerg Med. 2018 Dec;13(8):1173-1174. PMID: 30171584 MH - Aged MH - Aged, 80 and over MH - Chi-Square Distribution MH - Diuretics/adverse effects/therapeutic use MH - Female MH - France/epidemiology MH - Hospitalization/statistics & numerical data MH - Humans MH - Hypercalciuria/*classification/epidemiology/*etiology MH - Magnesium/*analysis/blood/classification MH - Male MH - Middle Aged MH - Nephrocalcinosis/*classification/epidemiology/*etiology MH - Prevalence MH - Proton Pump Inhibitors/adverse effects/therapeutic use MH - Renal Tubular Transport, Inborn Errors/*classification/epidemiology/*etiology MH - Retrospective Studies MH - Statistics, Nonparametric OTO - NOTNLM OT - Hypocalcemia OT - Hypokalemia OT - Hypomagnesemia OT - Mortality OT - Proton pump inhibitors EDAT- 2018/06/29 06:00 MHDA- 2019/05/29 06:00 CRDT- 2018/06/29 06:00 PHST- 2018/03/25 00:00 [received] PHST- 2018/06/16 00:00 [accepted] PHST- 2018/06/29 06:00 [pubmed] PHST- 2019/05/29 06:00 [medline] PHST- 2018/06/29 06:00 [entrez] AID - 10.1007/s11739-018-1898-7 [pii] AID - 10.1007/s11739-018-1898-7 [doi] PST - ppublish SO - Intern Emerg Med. 2018 Dec;13(8):1201-1209. doi: 10.1007/s11739-018-1898-7. Epub 2018 Jun 27.