title: Hypomagnesemia Induced by Long-Term Treatment with Proton-Pump Inhibitors.
abstract: In 2006, hypomagnesemia was first described as a complication of proton-pump inhibitors. To address this issue, we systematically reviewed the literature. Hypomagnesemia, mostly associated with hypocalcemic hypoparathyroidism and hypokalemia, was reported in 64 individuals on long-term proton-pump inhibitors. Hypomagnesemia recurred following replacement of one proton-pump inhibitor with another but not with a histamine type-2 receptor antagonist. The association between proton-pump inhibitors and magnesium metabolism was addressed in 14 case-control, cross-sectional studies. An association was found in 11 of them: 6 reports found that the use of proton-pump inhibitors is associated per se with a tendency towards hypomagnesemia, 2 found that this tendency is more pronounced in patients concurrently treated with diuretics, carboplatin, or cisplatin, and 2 found a relevant tendency to hypomagnesemia in patients with poor renal function. Finally, findings likely reflecting decreased intestinal magnesium uptake were observed on treatment with proton-pump inhibitors. Three studies did not disclose any relationship between magnesium metabolism and treatment with histamine type-2 receptor antagonists. In conclusion, proton-pump inhibitors may cause hypomagnesemia. In these cases, switching to a histamine type-2 receptor antagonist is advised.
authors.affiliation: Pediatric Department of Southern Switzerland, Ospedale San Giovanni, 6500 Bellinzona, Switzerland.
authors.forename: Simone
authors.initials: S
authors.lastname: Janett
authors.affiliation: Pediatric Department of Southern Switzerland, Ospedale San Giovanni, 6500 Bellinzona, Switzerland.
authors.forename: Pietro
authors.initials: P
authors.lastname: Camozzi
authors.affiliation: Pediatric Department of Southern Switzerland, Ospedale San Giovanni, 6500 Bellinzona, Switzerland.
authors.forename: Gabriëlla G A M
authors.initials: GG
authors.lastname: Peeters
authors.affiliation: Pediatric Nephrology, Children's Hospital and University, 3010 Bern, Switzerland.
authors.forename: Sebastiano A G
authors.initials: SA
authors.lastname: Lava
authors.affiliation: Pediatric Department of Southern Switzerland, Ospedale San Giovanni, 6500 Bellinzona, Switzerland ; Pediatric Nephrology, Children's Hospital and University, 3010 Bern, Switzerland.
authors.forename: Giacomo D
authors.initials: GD
authors.lastname: Simonetti
authors.affiliation: Pediatric Department of Southern Switzerland, Ospedale San Giovanni, 6500 Bellinzona, Switzerland ; Pediatric Neurology, Children's Hospital and University, 3010 Bern, Switzerland.
authors.forename: Barbara
authors.initials: B
authors.lastname: Goeggel Simonetti
authors.affiliation: Pediatric Department of Southern Switzerland, Ospedale San Giovanni, 6500 Bellinzona, Switzerland.
authors.forename: Mario G
authors.initials: MG
authors.lastname: Bianchetti
authors.affiliation: Pediatric Emergency Department, Foundation IRCCS Ca' Granda Ospedale Maggiore Policlinico, 20122 Milan, Italy.
authors.forename: Gregorio P
authors.initials: GP
authors.lastname: Milani