Symptomatic Hypomagnesemia in Children

孩童徵候性低血鎂症

曹永魁(Yong-Kwei Tsau) ； 蔡文友(Wen-Yu Tsai) ； 呂立(Frank L. Lu) ； 蔡文雄(Wen-Shiung Tsai) ； 陳炯暉(Chiung-Hui Chen)

《Acta Paediatrica Sinica》 39卷6期 (1998/12) Pp. 393-397

https://doi.org/10.7097/APS.199812.0393

摘要

自民國85年1月至87年6月共計24位住院孩童發生有徵候低血鎂症。低血鈣、高血磷、低血鉀是常見的電解質問題，抽搐發作、虛弱等爲常見徵候。最常引起徵候性低血鎂症的原因爲使用氨基配醣體等藥物引發之腎臟鎂流失，這些病童年齡較大，且常合併胃腸鎂流失，造成低血鎂。副甲狀腺素之分析指出，低血鎂性低血鈣之機轉，於大部分病童可能是副甲狀腺之制造成釋出受到抑制，於少數病童則可能是週邊組織對副狀腺素可逆性抗性所致。大部分病童於鎂補充後，徵候獲得改善而不再發生，僅一先天性腎臟鎂流失病童及兩原發性低血鎂病童需接受長期鎂治療。

關鍵字

低血鎂 ； 低血鈣 ； 低血鉀 ； 副甲狀腺功能低下

並列摘要

Between January 1996 and June 1998, 24 children with symptomatic hypomagnesemia were enrolled for analysis of their symptomatology, causes, and treatment outcome. Hypocalcemia and hyperphosphatemia suggesting impaired parathyroid function were the most common electrolyte disorders. Hypokalemia was also frequently noted. The related symptoms including seizure, tetany, and weakness were common. Drug-induced renal magnesium wasting was the most common cause of symptomatic hypomagnesemia, and tended to occur in older children using amino glycoside, furosemide, and amphotericin-B. The associated gastrointestinal causes might add a minor contribution to the development of hypomagnesemia. Analyses of PTH levels in 13 children suggested that inhibition of PTH synthesis or secretion was responsible for hypomagnesemic hypocalcemia in most patients. However, peripheral PTH resistance might also account for the mechanism in a few patients. In most patients, symptomatic hypomagnesemia was transient, and improved after magnesium provision. Only one child with con genital renal magnesium wasting and two with primary hypomagnesemia needed long-term magnesium treatment.

並列關鍵字

hypomagnesemia ； hypocalcemia ； hypokalemia ； hypoparathyroidism