Magnesium Oxide-Induced Hypermagnesemia in a Patient with Renal Insufficiency

高鎂血症是少見的，而有嚴重臨床症狀的高鎂血症更是少見。高鎂血症可以致死，但這是可以治療的疾病，所以及早發現、及早治療是重要的。臨床上，高鎂血症大多是因為嚴重腎衰竭者服用過量鎂製劑，或是在治療子癲前症或心律不整時給矛過量的硫酸鎂所造成。在此，我們報告一個高血鎂的病例，他因昏迷、呼吸衰竭、低血壓而被誤診為敗血症。這個病患因便祕而長期服用氧化鎂。在爭診室我們發現他有輕微的腎功能不良，而血鎂值為11.2mg/dl。我們給予藥物治療，症狀改善，但又復發。最後給予血液透析，終於改善。根據這個案例，除了腎衰竭的病人要避免給予鎂製劑之外，腎功能輕微不良者也需小心鎂製劑的給予。此外，緊急血液透析在處理高鎂血症是重要而有效的方法。

關鍵字

瀉劑；高鎂血症；腎功能不良

並列摘要

Hypermagnesemia is a rare laboratory finding, and life-threatening hypermagnesemia is even further rare; although it is reversible with early detection and treatment. Clinical hypermagnesemia usually results from excess exogenous magnesium intake in patients with severe renal failure or overdose infusion of magnesium salt in the cases of eclampsia and cardiac arrhythmias. Here, we present a case of hypermagnesemia, that had first been misdiagnosed as sepsis, presenting with coma, respiratory failure, hypotension, sinus bradycardia, areflexia, and hypothermia. This patient suffered from chronic constipation with regular use of magnesium oxide as laxative. In spite of mild renal insufficiency (Serum creatinine 2.0 mg/dl), hypermagnesemia of 11.2 mg/dl developed under the administration of magnesium oxide 250 mg per dose three times a day. Hemodialysis was performed due to severe symptomatic hypermagnesemia resistant to aggressive calcium gluconate, saline, and furosemide administration. His symptoms induced by hypermagnesemia subsided after hemodialysis. Accordingly, we suggest precautious use of magnesium of usual dose to treat constipation even in patients with mild renal insufficiency. We propose emergent hemodialysis may be life-saving in this clincial setting.

並列關鍵字

laxative ； hypermagnesemia ； renal insufficiency

國際替代計量

Magnesium Oxide-Induced Hypermagnesemia in a Patient with Renal Insufficiency

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