Hypermagnesemia
1059585
207595552
2008-04-23T13:06:28Z
Arcadian
104523
clean up - nav, Replaced: {{Metabolic pathology}} → {{Mineral metabolic pathology}} using [[Project:AutoWikiBrowser|AWB]]
{{Infobox_Disease |
Name = {{PAGENAME}} |
Image = Mg-TableImage.png |
Caption = [[Magnesium]] |
DiseasesDB = 6259 |
ICD10 = {{ICD10|E|83|4|e|70}} |
ICD9 = {{ICD9|275.2}} |
ICDO = |
OMIM = |
MedlinePlus = |
eMedicineSubj = med |
eMedicineTopic = 3383|
eMedicine_mult = {{eMedicine2|emerg|262}} {{eMedicine2|ped|1080}} |
MeshID = |
}}
'''Hypermagnesemia''' is an [[electrolyte disturbance]] in which there is an abnormally elevated level of [[magnesium]] in the blood. Usually this results in excess of magnesium in the body.
Hypermagnesemia occurs rarely because the [[kidney]] is very effective in excreting excess magnesium. It usually develops only in people with kidney failure who are given magnesium salts or who take drugs that contain magnesium (e.g. some [[antacid]]s and [[laxative]]s). It is usually concurrent with [[hypercalcemia]] and/or [[hyperkalemia]].
==Metabolism==
For a detailed description of magnesium [[homeostasis]] and [[metabolism]] see [[hypomagnesemia]].
==Symptoms==
* Weakness, nausea and vomiting
* Impaired breathing
* [[Hypotension]]
* [[Hypocalcemia]]
* [[Arrhythmia]] and [[Asystole]]
Though Arrhythmia and Asystole are possible cardiac outcomes of Hypermagnesemia, most cardiac symptoms are due to conduction delays, since magnesium acts as physiologic [[Calcium channel blocker|calcium blocker]].
Clinical consequences related to serumconcentration:
*4.0 mEq/l [[hyporeflexia]]
*>5.0 mEq/l Prolonged atrioventricular conduction
*>10.0 mEq/l Complete [[heart block]]
*>13.0 mEq/l [[Cardiac arrest]]
==Causes==
Since magnesium is excreted through the [[kidney]]s, [[renal failure]] (as a result of hypermagnesemia) most often occurs due to prolonged over supplementation or long term use of magnesium containing medications or laxatives.
===Predisposing conditions===
*[[Hemolysis]], magnesium concentration in erythrocytes is approximately three times greater than in serum, therefore hemolysis can increase plasma magnesium. Hypermagnesemia is expected only in massive hemolysis.
*[[Renal insufficiency]], excretion of magnesium becomes impaired when [[creatinine clearance]] falls below 30 ml/min. However, hypermagnesemia is not a prominent feature of renal insufficiency unless magnesium intake is increased.
*Other conditions that can predispose to mild hypermagnesemia are [[diabetic ketoacidosis]], [[adrenal insufficiency]], [[hyperparathyroidism]] and [[lithium]] [[intoxication]].
==Therapy==
Prevention of hypermagnesemia usually is possible. In mild cases, withdrawing magnesium suppletion is often sufficient. In more severe cases the following treatments are used:
* [[Intravenous]] [[calcium gluconate]], because the actions of [[magnesium]] in [[neuromuscular]] and [[cardiac]] function are antagonized by [[calcium]].
Definitive treatment of hypermagnesemia requires increasing renal magnesium excretion through:
* Intravenous [[diuretic]]s, in the presence of normal [[renal function]]
* [[Dialysis]], when kidney function is impaired and the patient is symptomatic from hypermagnesemia
{{Mineral metabolic pathology}}
[[Category:Electrolyte disturbances]]
[[Category:Magnesium]]
[[Category:Nephrology]]