Abstract
We describe two male infants suffering from primary hypomagnesaemia, diagnosed at 3 months and 2.5 months of age. They both presented with generalised convulsions, with case 2 exhibiting hypocalcaemia which did not respond to calcium and case 1 having normocalcaemia at first but hypocalcaemia 3 days after admission. Both improved dramatically after initiation of magnesium therapy. A carrier-mediated transport defect is the most likely cause of this disease. It is of the utmost importance that a correct and prompt diagnosis be made as therapy is simple and effective. Failure in diagnosing this condition could prove fatal as demonstrated in the family history of case 2.
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Anast CS, Mohs JM, Kaplan SL, Burns TW (1972) Evidence for parathyroid failure in magnesium deficiency. Science 177:606–608
Coenegracht JM, Houben HGJ (1974) Idiopathic hypomagnesemia with hypocalcemia in an adult. Clin Chim Acta 50:349–357
Connor TB, Toskes P, Mahaffey J, Martin LF, Williams JB, Walser B (1972) Parathyroid function during chronic magnesium deficiency. Johns Hopkins Med J 131:100–117
Estep H, Shaw WA, Watlington C, Hobe R, Holland W, Tucker STG (1969) Hypocalcemia due to hypomagnesemia and reversible parathyroid hormone unresponsiveness. J Clin Endocrinol Metab 29:842–848
Friedman M, Hatcher G, Watson L (1967) Primary hypomagnesaemia with secondary hypocalcaemia in an infant. Lancet I: 703–705
Garty R, Alkalay A, Bernheim JL (1983) Parathyroid hormone secretion and responsiveness to parathyroid hormone in primary hypomagnesemia. Isr J Med Sci 19:345–348
Heaton FW, Fourman P (1965) Magnesium deficiency and hypocalcemia in intestinal malabsorption. Lancet II:50–52
Heggtveit HA, Herman L, Mishra RK (1964) Cardiac necrosis and calcification in experimental magnesium deficiency. Am J Pathol 45:757
Kreijs GJ, Nicar MJ, Zerwekh JF, Norman DA, Kane MG, Pak CYC (1983) Effect of 1,25 dihydroxy vitamin D3 on calcium and magnesium absorption in the healthy human jejunum and ileum. Am J Med 75:973–976
Levi J, Massry SG, Coburn JW, Llach F, Kleeman CR (1974) Hypocalcemia in magnesium — depleted dogs: evidence for reduced responsiveness to parathyroid hormone and relative failure of parathyroid gland function. Metabolism 23:323–335
Milla PJ, Aggett PJ, Wolff OH, Harries JT (1979) Studies in primary hypomagnesaemia: evidence for defective carrier-mediated small intestinal transport of magnesium. Gut 20:1028–1033
Mimouni F, Tsang RC, Hertzberg VS, Miodovnik M (1986) Polycythemia, hypomagnesemia, and hypocalcemia in infants of diabetic mothers. Am J Dis Child 140:798–800
Muldowney FP, Mckenna TJ, Kyle LH, Freaney R, Swan M (1970) Parathormone-like effect of magnesium replenishment in steatorrhea. N Engl J Med 282:61–68
Nordio S, Donath A, Macagno F, Gatti R (1971) Chronic hypomagnesemia with magnesium dependent hypocalcemia. IA new syndrome with intestinal magnesium malabsorbtion. Acta Paediatr Scand 60:441–448
Paunier L, Radde IC, Kooh SW, Conen PE, Fraser D (1968) Primary hypomagnesemia with secondary hypocalcemia in an infant. Pediatrics 41:385–402
Salet J, Polonovski C, DeGouyon F, Pean G, Melekian B, Fournet JP (1966) Tetanie hypocalcemique recidivante par hypomagnesemie congenitale, une maladie metabolique nouvelle. Arch Fr Pediatr 23:749–768
Schindler AM (1984) Isolated neonatal hypomagnesaemia associated with maternal overuse of stool softener. Lancet II:822
Skyberg D, Stromme JH, Nesbakken R, Harnaes K (1968) Neonatal hypomagnesemia with selective malabsorbtion of magnesium — a clinical entity. Scand J Clin Lab Invest 21:355–363
Smales ORC (1974) Primary infantile hypomagnesaemia. Proc R Soc Med 67:29–30
Stromme JH, Mesbakken R, Normann T, Skjorten F, Skyberg D, Johannessen B (1969) Familial hypomagnesemia. Biochemical, histological and herediatary aspects studied in two brothers. Acta Paediatr Scand 58:433–444
Suh SM, Tashjian AH, Matsuo N, Parkinson DK, Fraser D (1973) Pathogenesis of hypocalcemia in primary hypomagnesemia, normal end-organ responsiveness to parathyroid hormone, impaired parathyroid gland function. J Clin Invest 52:153–160
Tsang RC, Strub R, Brown DR, Steichen JJ, Hartman C, Chen IW (1976) Hypomagnesemia in infants of diabetic mothers: perinatal studies. J Pediatr 89:115–119
Vainsel M, Vandevelde G, Smulders J, Vosters M, Hubain P, Loeb H (1970) Tetany due to hypomagnesaemia with secondary hypocalcaemia. Arch Dis Child 45:254–258
Van der Elst CW, Molteno CD, Malan AF, de Heese H (1980) The management of polycythaemia in the new born infant. Early Hum Dev 4:393–403
Wiegmann T, Kaye M (1977) Hypomagnesemic hypocalcemia. Early serum calcium and late parathyroid hormone increase with magnesium therapy. Arch Intern Med 137:953–955
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Abdulrazzaq, Y.M., Smigura, F.C. & Wettrell, G. Primary infantile hypomagnesaemia; report of two cases and review of literature. Eur J Pediatr 148, 459–461 (1989). https://doi.org/10.1007/BF00595914
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DOI: https://doi.org/10.1007/BF00595914