title: Proton pump inhibitors and symptomatic hypomagnesemic hypoparathyroidism.
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.
authors.affiliation: Department of Clinical and Experimental Medicine, School of Nephrology, University of Catania, A.O.U. "Policlinico-Vittorio Emanuele", Catania, Italy.
authors.forename: P
authors.initials: P
authors.lastname: Fatuzzo
authors.affiliation: Department of Clinical and Experimental Medicine, School of Nephrology, University of Catania, A.O.U. "Policlinico-Vittorio Emanuele", Catania, Italy.
authors.forename: G
authors.initials: G
authors.lastname: Portale
authors.affiliation: Department of Clinical and Experimental Medicine, School of Nephrology, University of Catania, A.O.U. "Policlinico-Vittorio Emanuele", Catania, Italy.
authors.forename: V
authors.initials: V
authors.lastname: Scollo
authors.affiliation: Department of Clinical and Experimental Medicine, School of Nephrology, University of Catania, A.O.U. "Policlinico-Vittorio Emanuele", Catania, Italy.
authors.forename: L
authors.initials: L
authors.lastname: Zanoli
authors.affiliation: Nephrology and Dialysis Unit, P.O. "San Giovanni di Dio", Agrigento, Italy. antonio.granata4@tin.it.
authors.forename: Antonio
authors.initials: A
authors.lastname: Granata
mesh_terms: D053799:2-Pyridinylmethylsulfinylbenzimidazoles / Q000009:adverse effects*; D000368:Aged; D015415:Biomarkers / Q000097:blood; D002526:Cerebellar Diseases / Q000139:chemically induced / Q000175:diagnosis; D019587:Dietary Supplements; D057915:Drug Substitution; D006801:Humans; D006996:Hypocalcemia / Q000097:blood / Q000139:chemically induced / Q000175:diagnosis; D007008:Hypokalemia / Q000097:blood / Q000139:chemically induced / Q000175:diagnosis; D007011:Hypoparathyroidism / Q000097:blood / Q000139:chemically induced* / Q000175:diagnosis / Q000628:therapy; D008274:Magnesium / Q000097:blood*; D008297:Male; D000077402:Pantoprazole; D054328:Proton Pump Inhibitors / Q000008:administration & dosage / Q000009:adverse effects*; D011761:Pyrrolidonecarboxylic Acid / Q000008:administration & dosage; D011899:Ranitidine / Q000008:administration & dosage; D012640:Seizures / Q000139:chemically induced / Q000175:diagnosis; D016896:Treatment Outcome
chemical_list: D053799:2-Pyridinylmethylsulfinylbenzimidazoles; D015415:Biomarkers; D054328:Proton Pump Inhibitors; D011899:Ranitidine; D000077402:Pantoprazole; D008274:Magnesium; D011761:Pyrrolidonecarboxylic Acid
keywords: Hypocalcemia; Hypokalemia; Hypomagnesemia; Hypoparathyroidism; Proton pump inhibitors