• 대한임상독성학회지
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• 제18권2호
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• pp.141-144
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• 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
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• 제56권7호
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• pp.308-311
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• 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
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• 제54권7호
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• pp.310-312
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• 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.

• 한국임상수의학회지
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• 제27권3호
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• pp.262-267
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• 2010

마그네슘($Mg^{2+}$)은 325 개 이상의 생리적 및 생화학적 과정에 필수적인 조효소이며 신경활성, 심장근 감수성, 신경근 전달, 근수축, 혈관운동 긴장과 혈압 등의 신체활동과 관련된 일련의 과정에서 중요한 역할은 한다. 하지만 신체활동과 관련된 혈액 이온화 $Mg^{2+}$ ($iMg^{2+}$)에 관한 보고는 거의 없을 뿐만 아니라 혈액 총 $Mg^{2+}$을 측정한 연구결과들은 논란의 여지가 있다. 대사적 요구가 증가하는 단기간의 고강도 운동에서 혈액 $iMg^{2+}$의 변화를 측정하였다. 고강도의 수영운동 후에 혈액 산도, 혈당, 중탄산염, 산소 및 칼슘은 감소한 반면, 젖산, 이산화탄소, $iMg^{2+}$, 나트륨, 칼륨은 유효한 증가를 보였다. 고강도 수영에서 혈액 $iMg^{2+}$의 변화는 혈액 산도, 혈당, 중탄산염과 칼슘의 변화와는 역관계의 상관을 보인 반면, 젖산과 음이온차와는 정관계의 유의한 상관을 보였다. 이 결과는 단기간 고강도의 수영운동이 고마그네슘혈증을 야기할 수 있고 이는 대사성 및 호흡성 산증에 의한 근육내 $iMg^{2+}$의 증가에 수반하는 근육에서의 $iMg^{2+}$ 유출의 증가에 의한 것으로 판단된다.

• Journal of Korean Neurosurgical Society
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• 제66권3호
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• pp.332-339
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• 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
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• 제7권2호
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• pp.169-171
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• 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.

• 한국임상수의학회지
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• 제28권6호
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• pp.581-585
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• 2011

자연적 혹은 인위적 환우 기간의 절식은 산란계에서 심각한 대사성 스트레스가 될 수 있다. 절식 그리고 필수적으로 수반되는 사료 재급여 증후군의 대사성 스트레스는 ATP 생성과 밀접한 $Mg^{2+}$, $K^+$과 P 등의 무기염류 불균형을 야기할 수 있다. $Mg^{2+}$은 생체 대상과정에서 필수적인 무기염류이며 스트레스는 생체 $Mg^{2+}$ 요구량을 증가시킬 뿐만 아니라 $Mg^{2+}$ 결핍을 야기할 수 있기 때문에 산란계에서 환우 기간의 절식에 관련된 혈액내 이온의 이온화 농도 및 결합형을 포함한 총농도의 변동을 관찰하였다. 환우 후에 대사성 스트레스와 관련된 생화학 인자의 변화와 수반하여 혈액내 $Mg^{2+}$과 $K^+$의 감소가 관찰되었다. 따라서 환우 기간의 절식 및 사료 재급여 증후군은 심각한 저마그네슘혈증 및 저칼륨혈증을 야기할 수 있으므로 환우 그리고 재급여 과정에서 $Mg^{2+}$과 $K^+$의 투여가 권장된다.

• 대한의생명과학회지
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• 제6권2호
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• pp.159-164
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• 2000

혈액 전해질 성분들에 대한 대장균 내독소의 영향을 조사하기 위해 토끼를 대상으로 한 동물실험을 실시하였다. 대장균 내독소 (혈청형 O55 : B5)를 토끼의 귀정맥을 통해 0.10 mg/kg 혹은 0.50 mg/kg 농도로 주입한 후 3, 6, 12, 24시간대에 채혈하여서 $Ca^{++}$, $Mg^{++}$, $Na^{+}$, $K^{+}$, Cl$^{-}$ 농도를 측정하였다. 대조군에 비해, 내독소투여 토끼의 $Ca^{++}$ 농도는 6시간대에 증가하였고, $Mg^{++}$ 농도는 3, 6, 12시간대에, $Na^{+}$과 $K^{+}$는 모든 채혈시간대에, 그리고 Cl$^{-}$ 농도는 3, 12, 24시간대에 각각 유의하게 높았다 (p<0.05). 흥미롭게도, 고 $Mg^{+}$ 혈증 (약 4.0 mg/dL)을 보인 내독소투여 토끼들은 심각한 임상징후들로 인식되는 분비물의 증가, 쇼크, 빈호흡, 경련, 혹은 설사와 같은 증세를 보였다. 본 연구의 결과들은 대장균 내독소가 혈액 전해질 농도의 항상성 혼란을 유도하며 이러한 생리적 불균형은 치명적 상황과 그로 인한 죽음을 야기할 수도 있음을 시사하고 있다.