• Journal of The Korean Society of Clinical Toxicology
• /
• v.18 no.2
• /
• pp.141-144
• /
• 2020

Hypermagnesemia is a rare condition that is usually iatrogenic in patients with elderly or renal failure. Severe hypermagnesemia is uncommon in patients with a normal renal function. Symptoms due to hypermagnesemia can range from mild symptoms, such as nausea, to severe symptoms, such as cardiac and respiratory arrest. This paper describes a case of a 49-year-old woman who ingested a magnesium-containing fertilizer with normal renal function. Cardiac arrest occurred eight hours after poisoning. Electrocardiography changed from a narrow QRS to a wide QRS and then to a complete atrioventricular block. Her hemodynamic state was unstable. Continuous renal replacement therapy was performed to remove magnesium from the blood, with the subsequent resolution of arrhythmia and hemodynamic stabilization. This paper reviews the pathophysiologic effects of magnesium on the cardiovascular system, clinical manifestation, and treatment of hypermagnesemia.

• Clinical and Experimental Pediatrics
• /
• v.56 no.7
• /
• pp.308-311
• /
• 2013

In this report, we present a pediatric case of severe symptomatic hypermagnesemia resulting from the use of magnesium oxide as a laxative in a child undergoing continuous cyclic peritoneal dialysis for end-stage renal disease. The patient showed abnormal electrocardiography (ECG) findings, such as tall T waves, a widened QRS complex, and irregular conduction, which were initially misdiagnosed as hyperkalemia; later, the correct diagnosis of hypermagnesemia was obtained. Emergent hemodialysis successfully returned the serum magnesium concentration to normal without complications. When abnormal ECG changes are detected in patients with renal failure, hypermagnesemia should be considered.

• Clinical and Experimental Pediatrics
• /
• v.54 no.7
• /
• pp.310-312
• /
• 2011

A preterm female infant born at 27 weeks of gestation with a birth weight of 990 g developed acute hypotonia, apnea, hypotension and bradycardia mimicking septic shock syndrome at 14h after birth. Laboratory tests indicated a severe hypermagnesemia of 45 mg/dL. The renal function, complete blood count and maternal blood concentrations of magnesium were normal, and the blood cultures were negative. The patient recovered with treatment including exchange transfusion. However, the etiology of the severe hypermagnesemia remains unknown.

• Journal of Veterinary Clinics
• /
• v.27 no.3
• /
• pp.262-267
• /
• 2010

Magnesium ($Mg^{2+}$) is an essential co-factor for over 325 physiological and biochemical processes so that plays a central role of neuronal activity, cardiac excitability, neuromuscular transmission, muscular contraction, vasomotor tone, and blood pressure significantly related to physical performance. However, only limited information on blood ionized $Mg^{2+}$ ($iMg^{2+}$) regarding to physical exercise is available and the data from blood total $Mg^{2+}$ detection are inconsistent. This present study investigated the changes of blood $iMg^{2+}$ correlated with metabolic demands during acute high-intensive exhaustive physical exercise in rats. After exhausted swimming (3-4 hours), blood pH, glucose, $HCO_3{^-}$, oxygen and ionized $Ca^{2+}$ ($iCa^{2+}$) were significantly decreased, whereas lactate, carbon dioxide, $iMg^{2+}$, ionized $Na^+$ and ionized $K^+$ were significantly increased. During the exhausted swimming, the changes in $iMg^{2+}$ showed a significant negative correlation with changes in pH, glucose, $HCO_3^-$ and $iCa^{2+}$, however a significant negative correlation with changes in lactate and anionic gap. It is concluded that the acute high-intensive exhaustive physical exercise could produced hypermagnesemia, an increase in blood $iMg^{2+}$ via stimulation of $iMg^{2+}$ efflux following increase in intracellular $iMg^{2+}$ from muscle induced by metabolic and respiratory acidosis.

• Journal of Korean Neurosurgical Society
• /
• v.66 no.3
• /
• pp.332-339
• /
• 2023

Objective : The present study aimed to investigate the clinical characteristics of electrolyte imbalance in patients with moderate to severe traumatic brain injury (TBI) who underwent craniotomy and its influence on prognosis. Methods : A total of 156 patients with moderate to severe TBI were prospectively collected from June 2019 to June 2021. All patients underwent craniotomy and intracranial pressure (ICP) monitoring. We aimed to explore the clinical characteristics of electrolyte disturbance and to analyze the influence of electrolyte disturbance on prognosis. Results : A total of 156 patients with moderate and severe TBI were included. There were 57 cases of hypernatremia, accounting for 36.538%, with the average level of 155.788±7.686 mmol/L, which occurred 2.2±0.3 days after injury. There were 25 cases of hyponatremia, accounting for 16.026%, with the average level of 131.204±3.708 mmol/L, which occurred 10.2±3.3 days after injury. There were three cases of hyperkalemia, accounting for 1.923%, with the average level of 7.140±1.297 mmol/L, which occurred 5.3±0.2 days after injury. There were 75 cases of hypokalemia, accounting for 48.077%, with the average level of 3.071±0.302 mmol/L, which occurred 1.8±0.6 days after injury. There were 105 cases of hypocalcemia, accounting for 67.308%, with the average level of 1.846±0.104 mmol/L, which occurred 1.6±0.2 days after injury. There were 17 cases of hypermagnesemia, accounting for 10.897%, with the average level of 1.213±0.426 mmol/L, which occurred 1.8±0.5 days after injury. There were 99 cases of hypomagnesemia, accounting for 63.462%, with the average level of 0.652±0.061 mmol/L, which occurred 1.3±0.4 days after injury. Univariate regression analysis revealed that age, Glasgow coma scale (GCS) score at admission, pupil changes, ICP, hypernatremia, hypocalcemia, hypernatremia combined with hypocalcemia, epilepsy, cerebral infarction, severe hypoproteinemia were statistically abnormal (p<0.05), while gender, hyponatremia, potassium, magnesium, intracranial infection, pneumonia, allogeneic blood transfusion, hypertension, diabetes, abnormal liver function, and abnormal renal function were not statistically significant (p>0.05). After adjusting gender, age, GCS, pupil changes, ICP, epilepsy, cerebral infarction, severe hypoproteinemia, multivariate logistic regression analysis revealed that hypernatremia or hypocalcemia was not statistically significant, while hypernatremia combined with hypocalcemia was statistically significant (p<0.05). Conclusion : The incidence of hypocalcemia was the highest, followed by hypomagnesemia, hypokalemia, hypernatremia, hyponatremia and hypermagnesemia. Hypocalcemia, hypomagnesemia, and hypokalemia generally occurred in the early post-TBI period, hypernatremia occurred in the peak period of ICP, and hyponatremia mostly occurred in the late period after decreased ICP. Hypernatremia combined with hypocalcemia was associated with prognosis.

• Animal cells and systems
• /
• v.7 no.2
• /
• pp.169-171
• /
• 2003

Sodium, potassium, calcium, zinc and magnesium levels in the serum of 31 patients diagnosed as acute myocardial infarction were analyzed on admission (within 24 Hours) and after 48 hours. The results were compared with those of 26 age matched controls. No significant difference was observed in the mean sodium, potassium, calcium and zinc levels between the cases and controls. Compared to the controls, however, the variation in the level of magnesium is highly significant at the time of admission as well as after 48 hours. When the risk factors like diabetes mellitus, hypertension, smoking and alcohol were considered, it is found that there is no significant difference between the risk groups as well as between the patients. The alteration in magnesium level in acute myocardial infarction is independent of these risk factors. Within the first 24 hours, the significant decrease in serum magnesium (35-51％ fall when compared with the control group), correlates with its entry into the cell following ischemia. From this hypomagnesemic state, it rises to 9-22 times after 48 hours. This hyper-magnesemia after 45 hours is probably due to the shift of magnesuim from the intracellular fluid compartment to the extracellular fluid compartment that follows cellular recovery. Therefore, including magnesium in the immediate management of acute myocardial infarction will be beneficial in the early recovery.

• Journal of Veterinary Clinics
• /
• v.28 no.6
• /
• pp.581-585
• /
• 2011

Either the fasting during natural molting or the starvation in induced molting would be a severe metabolic stress to laying hens. The metabolic stress during starvation and subsequent refeeding syndrome could lead to unbalance of mineral homeostasis, including $Mg^{2+}$, $K^+$ and P required by ATP synthesis. Since $Mg^{2+}$ is a fundamental ion for normal metabolic processes and stress may not only increase in demands of $Mg^{2+}$ but also produce consequence of $Mg^{2+}$ deficiency, we investigated the changes of blood ionized and total ions related to starvation during molting in laying hens. We founded the significant decrease in blood $Mg^{2+}$ and $K^+$ accompanied by the changes of biochemical parameters relating to increased metabolic stress after molting. These results suggested that appropriate $Mg^{2+}$ and $K^+$ supplements to laying hens could have beneficial effects during molting and subsequent refeeding that could produce a severe hypomagnesemia and hypokalcemia.

• Biomedical Science Letters
• /
• v.6 no.2
• /
• pp.159-164
• /
• 2000

We studied the effects of Escherichia coli (E. coli) endotoxin on blood electrolytes levels in rabbits. Endotoxin (5. coli serotype O55 : B5) was injected via rabbits' ear vein : 0.10 mg/kg (Group A) or 0.50 mg/kg (Group B). Blood samples were taken at postendotoxemic 3, 6, 12 and 24 hrs and were analyzed for detections of the levels of blood electrolytes such as $Ca^{++}$, $Mg^{++}$, Na$^{+}$, $K^{+}$ and Cl$^{-}$. As compared to control group, in endotoxin-treated rabbits $Ca^{++}$ levels elevated at 6 hrs but decreased at 24 hrs, $Mg^{++}$ levels were high at 3, 6 and 12 hrs, Na$^{+}$ and $K^{+}$ levels increased at all sampling times and Cl$^{-}$ levels rose at 3, 12 and 24 hrs (p<0.05). Interestingly, endotoxic rabbits having hypermagnesemia (about 4.0 mg/dL) showed severe syndromes such as increased secretion, shock, tachypnea, seizure and/or diarrhea, suggesting that these may be clinical signs of imminent death in rabbits. These observations testify that bacterial endotoxin leads to dyshomeostasis of blood electrolytes and the physiological imbalances may cause fatal disorders and subsequent death.