European Journal of Clinical Pharmacology

, Volume 73, Issue 4, pp 511–512 | Cite as

Seizure and tetany secondary to hypomagnesaemic hypoparathyroidism induced by a proton-pump inhibitor

  • Luca PasinaEmail author
  • Danilo Zanotta
  • Silvana Puricelli
  • Guido Bonoldi
Letter to the Editor

To the Editor

Severe PPI-associated hypomagnesaemia is a rare but potentially life-threatening adverse reaction that has recently emerged as a consequence of their widespread use [1, 2, 3, 4]. Neuromuscular signs of hypomagnesaemia are not generally seen until the plasma concentration of magnesium is lower than 0.5mmol/L (1.2mg/dL) but may occur in patients with severe hypomagnesaemia accompanied by severe hypocalcaemia as a consequence of profound hypoparathyroidism. In fact, although parathyroid hormone (PTH) secretion is stimulated by modest hypomagnesaemia and suppressed by hypermagnesaemia, paradoxically, it is inhibited by profound hypomagnesaemia [5].

Severe acute neurological symptoms including confusion, delirium, soporous state, major depression, disorientation and difficulty in ambulation have recently been described in patients with hypomagnesaemia induced by PPIs, suggesting caution in the chronic use of these drugs, especially among the elderly [6, 7, 8, 9, 10]. Serum...


Omeprazole Ranitidine Bisoprolol Serum Magnesium Multinodular Goiter 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.



We are grateful to J.D. Baggott for editorial assistance.

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.


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Copyright information

© Springer-Verlag Berlin Heidelberg 2016

Authors and Affiliations

  • Luca Pasina
    • 1
    Email author
  • Danilo Zanotta
    • 2
  • Silvana Puricelli
    • 2
  • Guido Bonoldi
    • 2
  1. 1.Pharmacotherapy and Appropriateness of Drug Prescription UnitIRCCS - Istituto di Ricerche Farmacologiche “Mario Negri”MilanoItaly
  2. 2.Internal Medicine IIOspedale di CircoloBusto ArsizioItaly

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