[Severe hypomagnesaemia due to proton pump inhibitor use].

BACKGROUND

Proton pump inhibitors (PPIs) are among the most widely used drugs around the globe. A growing body of literature, however, has reported numerous side effects, such as hypomagnesemia. Symptoms associated with hypomagnesaemia range from nausea, tetany and cardiac arrhythmias. Treatment of PPI-induced hypomagnesaemia involves discontinuation of the PPI and magnesium supplementation if needed.

METHODS

A 72-year-old female was admitted to the ICU with omeprazole-induced severe hypomagnesaemia twice during a one-year timespan, clinically manifested by tetany and respiratory failure due to acute decompensated heart failure following new onset atrial fibrillation. After discontinuation of the PPI and intravenous magnesium supplementation she recovered fully.

CONCLUSIONS

Hypomagnesaemia is a potentially serious adverse effect of PPIs. Serum magnesium levels should be monitored in chronic PPI-users with any neuromuscular, cardiovascular or non-specific symptoms, especially in the presence of known risk factors (alcohol use, malnutrition, malabsorption, hypertension and concomitant use of diuretics).