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Proton pump inhibitors and symptomatic hypomagnesemic hypoparathyroidism

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Abstract

Hypomagnesemia is a common but often overlooked problem in hospitalized patients. Unrecognized hypomagnesemia can cause serious complications. The association of hypokalemia and hypocalcemia is strongly evocative of a magnesium deficiency. Research into the causes of hypomagnesemia is imperative, as it will definitely change the approach, treatment and prognosis. We report the case of a 65-year-old man with chronic hypocalcemia and hypokalemia associated with cerebellar syndrome, a solitary seizure and cerebellar hyperintensities on magnetic resonance imaging. After the detection and treatment of hypomagnesemia with oral supplements of magnesium and the replacement of pantoprazole with ranitidine, we observed immediate relief of the symptoms. In conclusion, in clinical practice, magnesium depletion should be investigated in elderly patients with hypocalcemia treated with proton pump inhibitors for many years, in particular in the presence of neurological disorders.

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    Authors and Affiliations

    1. Department of Clinical and Experimental Medicine, School of Nephrology, University of Catania, A.O.U. “Policlinico-Vittorio Emanuele”, Catania, Italy

      P. Fatuzzo, G. Portale, V. Scollo & L. Zanoli

    2. Nephrology and Dialysis Unit, P.O. “San Giovanni di Dio”, Agrigento, Italy

      Antonio Granata

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    1. P. Fatuzzo
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    2. G. Portale
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    3. V. Scollo
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    4. L. Zanoli
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    5. Antonio Granata
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    Correspondence to Antonio Granata.

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    All procedures performed in this study involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

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    The subject included in this case report furnished written informed consent.

    Additional information

    P. Fatuzzo, L. Zanoli and A. Granata have contributed equally.

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    Fatuzzo, P., Portale, G., Scollo, V. et al. Proton pump inhibitors and symptomatic hypomagnesemic hypoparathyroidism. J Nephrol 30, 297–301 (2017). https://doi.org/10.1007/s40620-016-0319-0

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    • DOI: https://doi.org/10.1007/s40620-016-0319-0

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