Epsom Salt Ingestion Leading to Severe Hypermagnesemia Necessitating Dialysis

Walker, Philip J.; Parnell, Samuel; Dillon, Ryan C.

doi:10.1016/j.jemermed.2020.04.023

Cited by 7 publications

(3 citation statements)

References 17 publications

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“…The case of the patient described here draws parallels to a 2020 report by Philip et al on hypermagnesemia resulting from an Epsom salts overdose ( 44 ). In both instances, elderly patients displayed symptoms of magnesium toxicity, such as hypotension, shock, and respiratory failure, post magnesium sulfate administration.…”

Section: Discussionsupporting

confidence: 63%

Case report: Near-fatal hypermagnesemia resulting from the use of Epsom salts in a patient with normal renal function

Si,

Ge,

et al. 2024

Front. Med.

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Hypermagnesemia commonly occurs in patients with renal dysfunction. Diagnosing hypermagnesemia represents a challenge due to its rarity and the absence of routine monitoring of magnesium levels. Furthermore, the lack of awareness among clinicians regarding this uncommon condition frequently leads to delayed diagnoses. Few patients survive with a serum magnesium level exceeding 7 mmol/L. This article presents a case study of near-fatal hypermagnesemia resulting from the oral administration of Epsom salts in a patient with normal renal function. A 60-year-old female presented to the gastroenterology department on Oct. 6, 2023, with a 3-day history of black stools. She underwent subtotal gastrectomy in 2005 and has a stable history of nephrotic syndrome. To investigate the cause of her bleeding, electronic gastroscopy and colonoscopy were scheduled for Oct. 11, 2023. She experienced a sudden loss of consciousness 30 min after the ingestion of Epsom salts. The attending physician suspected a severe magnesium poisoning. She was promptly administered calcium gluconate, underwent tracheal intubation with ambu bag ventilation, and received early continuous renal replacement therapy (CRRT). Swift diagnosis and CRRT contributed to a reduction in her serum magnesium levels from an initial 8.71 mmol/L to 1.35 mmol/L, leading to a remarkable improvement in the toxic symptoms associated with hypermagnesemia. Subsequently, she was managed in the gastroenterology department, with gastroscopy revealing bleeding from the gastrointestinal anastomotic ulcer. Following conservative treatments including acid suppression, stomach protection, and hemostasis, her symptoms improved, and she was successfully discharged. This study aims to alert clinicians to the possibility of hypermagnesemia in individuals with normal renal function. Physicians should exercise caution when prescribing Epsom salts to patients with underlying gastrointestinal conditions. If necessary, alternative drug therapies may be considered to mitigate the risk of hypermagnesemia. Timely intervention is pivotal in averting life-threatening complications linked to hypermagnesemia.

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Section: Discussionsupporting

confidence: 63%

Case report: Near-fatal hypermagnesemia resulting from the use of Epsom salts in a patient with normal renal function

Si,

Ge,

et al. 2024

Front. Med.

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“…Epsom salts (rich in magnesium) being used as laxatives have been reported as causes of hypermagnesaemia that require emergent hospitalisations. 50,51 Calcium-alkali syndrome 31 and familial hypocalciuric hypercalcaemia 35,52 can result in magnesium toxicity because of decreased renal magnesium excretion. In familial hypocalciuric hypercalcaemia, there is an inactivating mutation in the calciumsensing receptor gene (CaSR).…”

Section: Excessive Absorptionmentioning

confidence: 99%

Causes of Hypermagnesaemia: A Literature Review

Qazi

Nakhoul

et al. 2021

EMJ Nephrol

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Magnesium is one of the commonly overlooked electrolytes, yet it plays a vital role in many of the processes in the human body. The balance of magnesium can translate into subtle changes in a person’s daily life, causing fatigue and confusion, to extreme cases that can end up causing central nervous system depression, respiratory failure, or cardiac arrhythmias. It is vital to be familiar with the physiology of magnesium regulation and knowledgeable regarding the causes that can lead to its toxicity to ensure the prevention of the possibly fatal condition. Magnesium balance can be summarised as the difference between magnesium intake and its excretion. Any factor overwhelming either of the two factors can cause pathological levels of the electrolyte. In addition to learning preventive measures to help patients against effects of magnesium toxicity, it is also important that the medical community trains to be able to treat cases of hypermagnesaemia. This review assesses the latest advancements in knowledge of magnesium metabolism, examines the case reports of hypermagnesaemia in an attempt to list the causes of magnesium toxicity, and enumerates management advances for the condition.

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“…Recientemente se han presentado reportes de casos con sobredosis de sales de Epsom o sulfato de magnesio (MgSO 4 ), usados en nuestro medio como antinflamatorio local o laxante [64].…”

Section: ■ Sales De Epsomunclassified

Trastornos electrolíticos inducidos por fármacos y sustancias tóxicas

et al. 2020

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Las enfermedades pueden generar un desequilibrio de electrolitos como parte de su fisiopatología, al igual que los medicamentos usados crónicamente y algunas sustancias tóxicas disponibles en nuestro medio. A pesar de todos los datos estadísticos existentes, la incidencia global de los trastornos electrolíticos secundarios a fármacos o sustancias tóxicas permanece desconocida, y, posiblemente, subregistrada; por lo tanto, el objetivo de esta revisión es analizar los trastornos electrolíticos que causan algunos medicamentos y sustancias tóxicas, y describir el mecanismo a través del cual se producen las alteraciones, en particular, del sodio, potasio, magnesio, calcio y fósforo, con el fin de alertar a los profesionales de la salud en el momento de enfrentarse a este tipo de condiciones en su práctica clínica. El conocimiento de los efectos adversos relacionados con medicamentos y tóxicos es importante para prevenir, identificar y gestionar de forma eficaz, complicaciones que son potencialmente peligrosas. Esta revisión pretende ser un referente de apoyo para los profesionales de la salud en estas situaciones.

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Epsom Salt Ingestion Leading to Severe Hypermagnesemia Necessitating Dialysis

Cited by 7 publications

References 17 publications

Case report: Near-fatal hypermagnesemia resulting from the use of Epsom salts in a patient with normal renal function

Case report: Near-fatal hypermagnesemia resulting from the use of Epsom salts in a patient with normal renal function

Causes of Hypermagnesaemia: A Literature Review

Trastornos electrolíticos inducidos por fármacos y sustancias tóxicas

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