title: Severe hypermagnesemia presenting with abnormal electrocardiographic findings similar to those of hyperkalemia in a child undergoing peritoneal dialysis.
abstract: In this report, we present a pediatric case of severe symptomatic hypermagnesemia resulting from the use of magnesium oxide as a laxative in a child undergoing continuous cyclic peritoneal dialysis for end-stage renal disease. The patient showed abnormal electrocardiography (ECG) findings, such as tall T waves, a widened QRS complex, and irregular conduction, which were initially misdiagnosed as hyperkalemia; later, the correct diagnosis of hypermagnesemia was obtained. Emergent hemodialysis successfully returned the serum magnesium concentration to normal without complications. When abnormal ECG changes are detected in patients with renal failure, hypermagnesemia should be considered.
authors.affiliation: Department of Pediatrics, Asan Medical Center Children's Hospital, University of Ulsan College of Medicine, Seoul, Korea.
authors.forename: Won Kyoung
authors.initials: WK
authors.lastname: Jhang
authors.forename: Yoon Jung
authors.initials: YJ
authors.lastname: Lee
authors.forename: Young A
authors.initials: YA
authors.lastname: Kim
authors.forename: Seong Jong
authors.initials: SJ
authors.lastname: Park
authors.forename: Young Seo
authors.initials: YS
authors.lastname: Park
keywords: Hyperkalemia; Magnesium; Peritoneal dialysis
references.citation: Anesth Analg. 2000 Nov;91(5):1160-2
references.pmid: 11049902
references.citation: N Engl J Med. 2003 Oct 2;349(14):1360-8
references.pmid: 14523145
references.citation: J Emerg Med. 1996 Mar-Apr;14(2):187-91
references.pmid: 8740750
references.citation: Rev Endocr Metab Disord. 2003 May;4(2):195-206
references.pmid: 12766548
references.citation: Intern Med. 2005 May;44(5):448-52
references.pmid: 15942092
references.citation: Pediatrics. 2000 Feb;105(2):E18
references.pmid: 10654978
references.citation: Gastroenterol Clin North Am. 2010 Sep;39(3):509-27
references.pmid: 20951915
references.citation: Int Urol Nephrol. 2009;41(2):357-62
references.pmid: 19274487
references.citation: Dis Colon Rectum. 2001 Aug;44(8):1201-9
references.pmid: 11535863
references.citation: Pediatrics. 2003 Jul;112(1 Pt 1):e70-2
references.pmid: 12837909
references.citation: J Emerg Med. 2002 Feb;22(2):185-8
references.pmid: 11858925
references.citation: Clin Biochem Rev. 2003 May;24(2):47-66
references.pmid: 18568054
references.citation: Intern Med. 2006;45(4):207-10
references.pmid: 16543690