Seizure and tetany secondary to hypomagnesaemic hypoparathyroidism induced by a proton-pump inhibitor
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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 .
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...
KeywordsOmeprazole Ranitidine Bisoprolol Serum Magnesium Multinodular Goiter
We are grateful to J.D. Baggott for editorial assistance.
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Conflict of interest
The authors declare that they have no conflict of interest.
- 4.Zipursky J, Macdonald EM, Hollands S, Gomes T, Mamdani MM, Paterson JM, Lathia N, Juurlink DN (2014) Proton pump inhibitors and hospitalization with hypomagnesaemia: a population-based case-control study. PLoS Med 11(9)Google Scholar